内窥镜括约肌切开术联合腹腔镜胆囊切除术治疗胆囊结石并胆总管结石  

Endoscopic sphincterotomy combined with laparoscopic cholecystectomy in the treatment of choledocholithiasis

作　　者：李诗杰[1] 秦长江[1] 

机构地区：[1]河南大学淮河医院普外科,开封475000

出　　处：《中国医师进修杂志（外科版）》2008年第3期33-35,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨内窥镜括约肌切开术（EST）联合腹腔镜胆囊切除术（LC）治疗胆囊结石并胆总管结石的疗效。方法选择2004年1月至2007年1月收治的141例胆囊结石并胆总管结石患者，随机抽取73例行EST联合LC（联合组），与同期行开腹胆囊切除术、胆道探查T管引流术68例（对照组）进行对比分析。结果联合组手术时间[（90．5±15．1）h]、住院时间[（9．2±2．5）d]、术后排气时间[（1．8±0．7）d]均短于对照组[分别为（138．1±36．6）h、（16．9±3．9）d、（3．3±0．9）d]（P〈0．05）。两组并发症发生率及住院费用比较差异无统计学意义。结论EST联合LC治疗胆囊结石并胆总管结石，创伤小，患者住院时间短，胃肠功能恢复快，充分体现了内窥镜、腹腔镜的优越性，优于传统开腹胆囊切除术。Objective To investigate the treatment method and effect of choledocholithiasis with endoscopic sphincterotomy （EST） combined with laparoscopic cholecystectomy （LC）. Methods One hundred and forty-one patients with choledocholithiasis were selected randomly from January 2004 to January 2007,73 patients were treated by EST combined with LC as united group,another 68 patients as control group were simultaneously performed open cholecystectomy and common bile duct exploration lithotomy. Results The average operative time （90.5 ± 15.1 ）h, hospitalization days （9.2 ± 2.5 ）d and the average gastrointestinal function recovery time（ 1.8 ± 0.7）d in united group were much shorter than those in control group （ 138.1 ± 36.6）h, （ 16.9 ± 3.9）d, （3.3 ± 0.9）d, respectively. The complication rates and the cost of hospitalization had no statistical difference between the two groups （P 〈 0.05 ）. Conclusion EST combined with LC is a microtrauma management with less pain and faster recovery. It thoroughly shows the advantages of endoscopy and laparoscopy and expands the scope of treating extrahepatic biliary duct stones by mini-invasive surgery. It is superior to open cholecystectomy.

关 键 词：括约肌切开术 内窥镜 胆囊切除术 腹腔镜 胆结石 

分 类 号：R657.42[医药卫生—外科学] R657.4[医药卫生—临床医学]