ERCP与开腹胆道探查手术对LC术后胆总管残余结石再次手术患者的价值  

Value of ERCP and open biliary tract exploration surgery for patients with residual common bile duct stones undergoing reoperation after LC

作　　者：狄淑群 徐则宽 张国新[3] 吴醒 DI Shu-qun XU Ze-kuan ZHANG Guo-xin et al(Department of General Surgery, Liyang City People＇s Hospital, Liyang 213300, China)

机构地区：[1]溧阳市人民医院普外科,213300 [2]江苏省人民医院普外科 [3]江苏省人民医院消化内科

出　　处：《中国实用医药》2017年第27期28-30,共3页China Practical Medicine

摘　　要：目的探讨经内镜逆行性胰胆管造影术(ERCP)与开腹胆道探查手术对腹腔镜胆囊切除术(LC)术后胆总管残余结石再次手术患者的价值。方法 80例LC术后胆总管残余结石患者,随机分为研究组(接受ERCP)和对照组(接受开腹胆道探查手术),各40例。对比两组患者的手术出血量、手术时间、术后住院时间、住院费用及术后并发症发生情况。结果两组患者手术均获得成功。研究组手术出血量少于对照组、手术时间及术后住院时间短于对照组、住院费用少于对照组,差异均具有统计学意义(t=38.866、20.666、7.970、3.096,P<0.05)。研究组术后并发症发生率(7.5%)低于对照组(25.0%),差异具有统计学意义(P<0.05)。结论与开腹胆道探查手术相比,ERCP对LC术后胆总管残余结石的手术效果更好,术后并发症发生率低,住院时间短。Objective To investigate the value of endoscopic retrograde cholangiopancreatography （ERCP） and open biliary tract exploration surgery for patients with residual common bile duct stones undergoing reoperation after laparoscopif cbolecystectomy （LC）. Methods A total of 80 patients with residual common bile duct stones undergoing reoperation after LC were randomly divided into research group （receiving ERCP） and control group （receivin;open biliary tract exploration surgery）, with 40 cases in each group. Comparison were made on surgical bleeding volume, operation time, postoperative hospitalization time, hospitalization costs and postoperative complications in two groups. Results Both groups had successful operations. The research group had less surgical bleeding volume than the control group, and shorter operation time, postoperative hospitalization time than the control group and less hospitalization costs than the control group. Their difference was statistically significant （t=38.866, 20.666, 7.970, 3.096, P〈0.05）. The research group had lower incidence of postoperative complications （7.5%） than the control group （25.0%）, and the difference was statistically significant （P〈0.05）. Conclusion Compared with open biliary tract exploration surgery, ERCP shows better surgical effect for residual common bile duct stones after LC with less complication rate and shorter hospitalization time.

关 键 词：经内镜逆行性胰胆管造影术 开腹胆道探查手术 腹腔镜胆囊切除术 胆总管残余结石 

分 类 号：R657.4[医药卫生—外科学]