| [Objective] to investigate the laparoscopy combined with choledochoscopy in gallbladder polyp extirpation of the clinical application of intraoperative indications, methods and clinical value.[Methods] from2009January to2014January in JiNan Central hospital of the laparoscopic minimally invasive gallbladder polyp were242cases for the observation group, polypoid lesions of the gallbladder were selected in our hospital over the same period of laparoscopic cholecystectomy (PLG) in96cases as control group, the clinical data of two groups divided patients (such as age, gender, age, gender, duration of PLG diameter, PLG number, complications, pathological type, operation time, bleeding volume, the number of analgesics, postoperative exhaust time, bed time, postoperative hospitalization time, cost of hospitalization, complications, common bile duct width, symptomatic grading, quality of life value and so on), the two clinical groups were analyzed using statistical methods, to summarize the clinical effect of laparoscopy combined with choledochoscopy in minimally invasive gallbladder polyp excision in the treatment of gallbladder polyps, and combining domestic and foreign related literatures to discuss the operation’s necessity, feasibility and limitation, safety and superiority of.[results] the control group and the observation group of patients with pathological results of PLG ratio from more to less were cholesterol polyp (70.83%,71.90%), adenoma (17.71%,17.36%), inflammatory polyps (6.25%,6.61%), adenomyosis (3.13%,2.89%), fibroepithelial polyp (2.08%,1.24%). The control group and the observation group differences in the proportion of different pathological types were not obvious, were not statistically significant (P>0.05); the patients in observation group operation time (53.48±13.08) min, ambulation time (11.45±2.08) h, postoperative hospitalization time (4.24±0.94) d,(12.85±2.15) thousand yuan cost of hospitalization and other indicators with the patients in the control group were (45.31±14.19) min,(12.35±2.16) h,(12.34±2.08) thousand yuan differences are not obvious, no statistically significant (P>0.05); the observation group patients intraoperative blood loss (10.0±2.75) ml, postoperative exhaust time (16.34±2.64) h and complications occurrence rate (2.07%) was significantly lower than the control group (22.5±5.25) ml,(22.64±2.67) h,(3.12),there is statistically significant (P&It;0.05); observation group patients with common bile duct width (5.92±0.51) mm Significantly less than patients in the control group (8.21±0.42) mm, the difference between groups was statistically significant (P<0.05); the patients in observation group the late symptom grade I ratio (85.54%) was significantly higher than that in control group (67.80%patients), and the grade Ⅱ (13.22%), Ⅲ (1.24%) was significantly lower than the control group patients (22.03%),(10.17%), the difference between the above groups were statistically significant (P<0.05).[Conclusion] the laparoscopic minimally invasive gallbladder polyp excision in the treatment of PLG is safe and effective, with less trauma, faster postoperative recovery, shorter hospitalization time, less cost in hospital, patients with less bleeding, postoperative intestinal function recovery, high degree of long-term remission of symptoms, quality of life is high, while preserving the gallbladder function at the same time, avoids a series of clinical symptoms and the risk caused by cholecystectomy. As a new surgery’s clinical treatment of PLG, the laparoscopic minimally invasive gallbladder polyps with high clinical application value in the operation, strictly grasp the indications and contraindications of the premise, it is worthy of popularization and application in clinical practice. |
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