ERCP在胃大部切除消化道重建毕Ⅱ术后胆总管结石患者的应用  

Application of ERCP on choledocholithiasis in patients with Billroth Ⅱ gastrectomy

作　　者：陈圣雄[1] 郝子佳 金成 屈志刚 段佳悦 王文斌[1] CHEN Sheng-xiong;HAO Zi-jia;JIN Cheng;QU Zhi-gang;DUAN Jia-yue;WANG Wen-bin(Department of Hepatobiliary Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Dermatology,Traditional Chinese Medicine Hospital of Shijiazhuang,Hebei Province,Shijiazhuang 050051,China;The third Department of Surgery,General Hospital of Jizhong Energy Fengfeng Group Company Limited,Hebei Province,Handan 056200,China)

机构地区：[1]河北医科大学第二医院肝胆外科,河北石家庄050000 [2]河北省石家庄市中医院皮肤科,河北石家庄050051 [3]冀中能源峰峰集团有限公司总医院外三科,河北邯郸056200

出　　处：《河北医科大学学报》2019年第4期429-432,共4页Journal of Hebei Medical University

摘　　要：目的通过胃大部切除消化道重建毕Ⅱ术后胆总管结石患者行腹腔镜胆道探查取石与内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)取石的对照研究,评价胃大部切除消化道重建毕Ⅱ术后胆总管结石患者行ERCP取石的临床疗效。方法胃大部切除毕Ⅱ式吻合术后胆总管结石61例患者根据行手术取石治疗方式分为腹腔镜组35例、ERCP组26例,比较2组取石成功率、手术操作时间、术后下床活动时间、术后住院时间、并发症发生率、住院费用等指标。结果 ERCP组取石成功率低于腹腔镜组,手术操作时间、术后下床活动时间、术后住院时间短于腹腔镜组,并发症少于腹腔镜组,住院费用低于腹腔镜组,差异均有统计学意义(P<0.05)。结论胃大部切除消化道重建毕Ⅱ式吻合术后胆道结石患者行ERCP取石,创伤更小,恢复更快,费用更少,值得推广。Objective To evaluate the clinical effect of endoscopic retrograde cholangiopancreatography(ERCP)on choledocholithiasis in patients with Billroth Ⅱ gastrectomy through the comparative study of the laparoscopic choledochotomy and ERCP on choledocholithiasis in patients with Billroth Ⅱ gastrectomy.Methods According to the way of operation,61 patients with choledocholithiasis with Billroth Ⅱ gastrectomy were divided into laparoscopic group(35 cases)and ERCP group(26 cases).The success rate of stone removal,the operation time,the time of getting out of bed after operation,the time of hospitalization after operation,the complications and the hospitalization cost were compared between the two groups.Results The success rate of stone removal in ERCP group was lower than that in laparoscopy group,but the operation time,the time of getting out of bed after operation,the time of hospitalization after operation in ERCP group were less than that in laparoscopy group,the complications were less than that in laparoscopy group,and the hospitalization cost was less than that in laparoscopy group,with statistical significance(P<0.05).Conclusion ERCP on choledocholithiasis in patients with Billroth Ⅱ gastrectomy has less trauma,faster recovery and less cost,which is worth popularizing.

关 键 词：胆总管结石 胰胆管造影术 内窥镜逆行 胃切除术 

分 类 号：R575.7[医药卫生—消化系统]