腹腔镜联合十二指肠镜同期治疗胆囊结石并肝外型肝胆管结石  

Combined endoscopic- laparoscopic techniques for one- stage treatment of concomitant cholelithiasis and choledocholithiasis

作　　者：吴君正 许晓飞[3] 刘浩[1] 李国新[1] 

机构地区：[1]南方医科大学南方医院普外科,广东广州510515 [2]清远市人民医院肝胆外科,广东清远511518 [3]清远职业技术学院,广东清远511510

出　　处：《南方医科大学学报》2013年第11期1656-1660,共5页Journal of Southern Medical University

基　　金：清远市科技局科研计划项目(2011B011112015)

摘　　要：目的探讨腹腔镜胆囊切除术(LC)联合经十二指肠镜逆行胆胰管造影(ERCP)同期治疗胆囊结石并肝外型肝胆管结石的临床疗效及意义。方法回顾性分析LC联合ERCP同期治疗胆囊结石并肝外型肝胆管结石30例患者(A组)和LC联合腹腔镜胆总管探查(1aparoscopic common bile duct exploration,LCBDE)32例患者(B组)的临床资料,对两组患者的手术时间、术中出血量、中转开腹数、术后下床活动时间、结石残留率、术后并发症、住院总费用和平均总住院日等指标进行对比分析。结果研究结果提示两种术式的住院总费用及平均总住院日差异有统计学意义(P<0.05),而手术时间、术中出血量、中转开腹、术后下床活动时间、结石残留率及手术并发症差异无统计学意义(P>0.05)。结论腹腔镜联合十二指肠镜同期治疗胆囊结石并肝外型肝胆管结石具有恢复快、住院时间短等优点,可能是一种安全、可行的微创手术方式。Objective To assess the clinical effects of combined endoscopic-laparoscopic technique for one-stage treatment of cholelithiasis with concomitant choledocholithiasis. Methods A retrospective analysis was conducted of the clinical data of 30 patients （Group A） with cholelithiasis and choledocholithiasis receiving one-stage laparoscopic cholecystectomy （LC） combined with intraoperative encoscopic retrograde cholangio-pancreatography （ERCP） and 32 patients （Group B） receiving LC combined with laparoscopic common bile duct exploration. The operative time, blood loss, conversion to open surgery rate, time to postoperative ambulation, calculi residual rate, hospitalization cost and length of hospital stay were analyzed comparatively. Results There were statistically differences between the two groups in hospitalization cost and length of hospital stay （P〈0.05） but not in the other indices （P〉0.05）. Conclusion Combined endoscopic-laparoscopic techniques can be a safe and feasible option for one-stage treatment of concomitant cholelithiasis and choledocholithiasis to allow rapid postoperative recovery with a shortened hospital stay.

关 键 词：腹腔镜胆囊切除术 胆囊结石 肝外型肝胆管结石 经内镜逆行胆胰管造影 经内镜乳头肌切开 

分 类 号：R657.4[医药卫生—外科学]