腹腔镜、内镜联合技术在胆囊结石合并胆总管结石患者中的应用  

Application of United Technologies of Laparoscopic and Endoscopic in Patients of Gallbladder Stones Combined with Common Bile Duct Stones

作　　者：王海峰[1] 刘建军[1] 胡国超[1] 

机构地区：[1]北京市房山区第一医院普外科,北京102400

出　　处：《医学综述》2011年第24期3820-3821,共2页Medical Recapitulate

摘　　要：目的探讨腹腔镜胆囊切除术(LC)联合术中内镜下逆行胆胰管造影(ERCP)及乳头括约肌切开(EST)取石一期治疗胆囊结石合并胆总管结石的可行性和安全性。方法选取我院2008年1月至2010年12月应用LC联合术中ERCP一期治疗胆囊结石合并胆总管结石患者15例为观察组,选择同期采用传统开腹胆囊切除、胆总管探查取石T管引流治疗的患者25例作为对照组,比较分析两组患者的临床治疗情况。结果两组患者均手术成功,取石成功率均为100%;观察组的手术时间长于对照组,但术后通气时间和术中出血量及住院时间明显少于对照组,组间比较差异均有统计学意义(P<0.05);观察组的并发症发生率低于对照组,两组比较差异有统计学意义(P<0.01),安全性更好。结论 LC联合术中ERCP一期治疗胆囊结石合并胆总管结石安全、有效,有利于患者的恢复,值得临床关注。Objective To explore the feasibility and safety of laparoseopic cholecystectomy （LC）combined with endoscopic retrograde cholangiopancreatography（ERCP） during operation and endoscopic sphincterotomy（EST） as the first phase treatment for patients with gallbladder stones with bile duct stones. Methods 15 cases of gallbladder stones with common bile duct stones from January 2008 to December 2010 treated with LC combined with ERCP were selected as observation group, another 25 patients of the same period treated with conventional open cholecystectomy,common bile duct exploration T-tube drainage were selected as the contreal group, analysis and comparison on clinical treatment of the two groups was done. Results Oper- ations of the two groups were all successful ,stone extraction rate both 100%. Operation time of the observa- tion group was longer than the control group, while the postoperation ventialtion time, blood loss during the operation and hospitalization time were much leas. The differences between the two groups were statistically significant（P 〈0.05 ）. Incidence of complication in observation group was less than the control group（ P 〈 0.01 ）, suggesting a better safety. Conclusion LC combined with ERCP during the operation treating period one gallbladder stones with bile duct stones is safe and effective, better for patients recovery, which deserves clinical attention.

关 键 词：胆囊结石 腹腔镜 内镜下逆行胆胰管造影 

分 类 号：R657.4[医药卫生—外科学]