ERCP联合腹腔镜同台序贯治疗胆总管结石并胆囊结石的临床研究  

Clinical study of ERCP combined with laparoscopic cholecystectomy in the treatment of the gallbladder and common bile duct stones

作　　者：苏剑东[1] 江堤[1] 刘美红[1] 黎东伟[1] 廖秀敏[1] 杨巧玲[1] 

机构地区：[1]东莞东华医院,广东东莞523110

出　　处：《泰山医学院学报》2016年第5期500-502,共3页Journal of Taishan Medical College

摘　　要：目的评价ERCP联合腹腔镜同台序贯治疗胆总管结石并胆囊结石的价值及安全性。方法收集我院2013年10月—2015年10月间接诊的患胆囊结石并胆总管结石的96例患者进行临床研究,按照随机、对照、双盲的原则将所有患者随机分成研究组与对照组,每组各包含48例患者。对照组48例患者施行传统开腹手术进行治疗,研究组48例患者则在同一次手术中,先行腹腔镜下胆囊切除术(LC),后行ERCP取石术进行治疗。观察和记录两组患者的术中情况、术后情况及并发症发生情况,并进行比较分析。结果经治疗后,两组患者均全部取石成功,且均无残余结石。研究组患者的术后肛门排气时间、术中出血量及住院天数均显著低于对照组(P<0.05),研究组患者的并发症发生率显著低于对照组(P<0.05)。结论同台序贯联合LC及ERCP是治疗胆总管结石(最大直径≤1.5 cm,个数≤3枚)合并胆囊结石安全有效的方法,值得推广。Objective ： To evaluate the value and safety of the ERCP combined with laparoscopic eholecystectomy in the treatment of the gallbladder and common bile duct stones on the sequential operation. Methods： Ninty-six patients with common bile duct stones and gallbladder stones diagnosed in our hospital from October, 2013 to October, 2015 were taken as the research objects, and these patients were randomly divided into the control group and the study group according to the randomized, controlled, double-blind principle, with 48 patients in each group. In the control group, 48 patients were treated with traditional open surgery while the study group had LC surgery first, then ERCP stone removal. After the opera- tion, the postoperative situation and the occurrence of complications of two groups of patients were observed and recorded and comparatively analyzed. Results ： After treatment, two groups of patients had the successful removal of the stones, and there were no residual stones. The postoperative anal exhaust time, the amount of bleeding and hospitalization days in the study group of patients were significantly lower than those in the control group （ P 〈 0. 05 ）, and there was statistical signifi- cance. The incidence of complications rate in the study group was significantly lower than that in the control group （ P 〈 0.05）, and there was statistical significance. Conclusion： The ERCP combined with laparoseopic choleeystectomy in the treatment of the gallbladder and common bile duct stones （the maximum diameter≤ 1.5cm, and the stone numbers ≤3 ） are safe and effective, which should be oromoted.

关 键 词：ERCP 腹腔镜下胆囊切除术 胆总管结石 胆囊结石 

分 类 号：R657.42[医药卫生—外科学]