两种微创治疗方案治疗继发性胆总管结石的临床对照研究  

A clinical comparison of two strategies for minimal invasive treatment of secondary common bile duct stone

作　　者：韩威[1] 蒋伟[1] 金岚[1] 李建设[1] 张忠涛[1] 

机构地区：[1]首都医科大学附属北京友谊医院普外科,100050

出　　处：《中华外科杂志》2009年第5期353-355,共3页Chinese Journal of Surgery

基　　金：北京市优秀人才培养资助项目（20081D0300100060）

摘　　要：目的比较腹腔镜胆囊切除＋经胆囊管胆道探查术（LC＋LTCBDE）与十二指肠镜乳头切开取石术＋腹腔镜胆囊切除术（EST＋LC）两种微创治疗方案治疗继发性胆总管结石的临床效果。方法根据所采用的病例筛选标准，筛选2005年6月至2007年11月首都医科大学附属北京友谊医院普外科收治的88例继发性胆总管结石患者，并根据其治疗方案不同分为两组，其中LC＋LTCBDE组45例，EST＋LC组43例。对两组患者的手术成功率、术后并发症发生率、住院时间、住院费用等指标行对照研究，并对患者的预后进行随访观察。结果两组手术成功率、并发症发生率无显著差异（P〉0．05），而平均住院时间及住院费用Lc＋LTCBDE组显著低于EST＋LC组（P〈0．05）。所有病例随访1年以上均无结石复发。结论与EST＋LC相比，LC＋LTCBDE在治疗继发性胆总管结石方面具有更大的微创优势。Objective To compare the clinical efficiency of two strategy in the treatment of secondary common bile duct stones： laparoscopic cholecystectomy with transcytic common bile duct exploration （ LC ＋ LTCBDE）, or laparoscopic cholecystectomy after endoscopic sphincterotomy （ EST ＋ LC）. Methods According to the screening standard, 88 patients with secondary bile duct stones （43 cases in LC ＋ LTCBDE group ,45 cases in EST ＋ LC group） who were treated from June 2005 to November 2007 were analyzed retrospectively. The achievement ratio, complications, average hospital stay and cost between two groups were compared. And all patients were followed up. Results There were no significant differences on achievement ratio and complications between two groups （ P 〉 0. 05 ） . The LC ＋ LTCBDE group has significantly shorter hospital stay and lower cost（ P 〈 0. 05 ）. There were no recurrence in 1 year. Conclusions LTCBDE is a promising strategy which has more advantages in the minimal invasive treatment of secondary common bile duct stones.

关 键 词：胆总管结石 腹腔镜检查 治疗 

分 类 号：R686[医药卫生—骨科学]