腹腔镜联合ERCP与开腹治疗胆囊结石合并胆总管结石的疗效对比  

Comparison Curative Effect of Laparoscopy Combined With ERCP and Laparotomy in Treatment of Gallbladder Stones and Choledocholithiasis

作　　者：高鹏程[1] 

机构地区：[1]河西学院附属张掖人民医院普外科,甘肃张掖734000

出　　处：《中国继续医学教育》2016年第13期121-122,共2页China Continuing Medical Education

摘　　要：目的对腹腔镜联合ERCP与开腹治疗胆囊结石合并胆总管结石的疗效进行研究与判定。方法回顾分析收治的200例胆囊结石合并胆总管结石患者,其中给予开腹治疗的80例患者作为对照组,腹腔镜联合ERCP治疗的120例患者作为微创组,并观察两组胆囊结石合并胆总管结石患者的术后48 h内疼痛情况、48h内肛门排气的情况、及术后并发症的发生概率(术后胰腺炎、术后出血、胆管炎及胆漏)。结果开腹组与微创组患者手术均获得成功。微创组未出现胃肠道穿孔、大出血和胆道损伤患者,其中微创组(腹腔镜联合ERCP手术中无中转开腹患者。微创组患者术后48h疼痛情况及排气情况均优于开腹组);术后两组胆囊结石合并胆总管结石患者的术后并发症发生概率无显著差异,P>0.05。结论给予腹腔镜联合ERCP治疗胆囊结石合并胆总管结石患者能够显著改善48h内患者排气概率及48h后术后排气情况,且术后痛苦轻、恢复快、术后并发症少。Objective Efficacy of laparoscopy combined ERCP versus open treatment of gallbladder and common bile duct stones were studied and determined.Methods A retrospective analysis of 200 cases treated gallbladder and common bile duct stones in patients, where treatment of abdominal given as a control group of 100 patients, laparoscopy combined with ERCP 100 patients were treated as the minimally invasive group, and two groups were observed gallstone biliary duct stones in patients postoperative pain 48 hours, the probability of occurrence of the situation within 48h lfatus, and postoperative complications （pancreatitis, bleeding, cholangitis and bile leakage）.ResultsLaparotomy group with minimally invasive surgery patients were successful. Minimally invasive group did not appear gastrointestinal perforation, bleeding, and patients with bile duct injury, laparoscopic surgery combined with ERCP without laparotomy patients. Postoperative pain at MIS group 48h and exhaust conditions are better than laparotomy group; two groups after gallbladder and common bile duct stones in patients with postoperative complications probability of no signiifcant difference,P〉0.05.Conclusion ERCP give laparoscopy combined therapy in patients with gallbladder and common bile duct stones can signiifcantly improve the probability of the exhaust gas within 48h and 48h after surgery in patients with exhaust case, and postoperative pain, faster recovery, less postoperative complications.

关 键 词：ERCP LC 胆囊结石 胆总管结石 

分 类 号：R575.6[医药卫生—消化系统]