胆囊结石合并胆总管结石两种微创治疗方式效果比较  

Comparison of two minimally invasive treatments for cholecystolithiasis complicated with choledocholithiasis

作　　者：姚志勲 彭启全[2] 姚少霖 YAO Zhi-xun;PENG Qi-quan;YAO Shao-lin(Department of General Surgery, Chaoyang District People′s Hospital, Shantou City, Guangdong 515100, China)

机构地区：[1]汕头市潮阳区人民医院普外科,广东515100 [2]中山大学汕头附属医院普外科,汕头515143

出　　处：《中国临床新医学》2020年第10期1040-1043,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的对比腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)+腹腔镜胆总管探查术(laparoscopic common bile duct exploration,LCBDE)与内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)+内镜十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)+LC治疗胆囊结石合并胆总管结石的临床效果。方法将100例胆囊结石合并胆总管结石患者随机分为观察组(n=52)和对照组(n=48)。观察组行LC+LCBDE;对照组行ERCP+EST,1~3 d后再行ERCP+EST+LC。比较两组患者的临床指标。结果观察组住院费用、手术时间、住院天数比对照组减少,差异有统计学意义(P<0.05)。两组患者胆结石清除成功率、并发症发生率、复发率比较,差异无统计学意义(P>0.05)。结论LC+LCBDE与ERCP+EST+LC治疗胆囊结石合并胆总管结石同样安全有效,但是LC+LCBDE住院时间较短,住院费用较少,可作为EST失败后的有效补救手术方式。Objective To compare the clinical effects of laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)and endoscopic retrograde cholangiopancreatography(ERCP)+endoscopic sphincterotomy(EST)+LC in treatment of cholecystolithiasis complicated with choledocholithiasis.Methods One hundred patients with cholecystolithiasis complicated with choledocholithiasis were randomly divided into the observation group(n=52)(receiving LC+LCBDE)and the control group(n=48)(receiving ERCP+EST for 1~3 days,and then receiving ERCP+EST+LC).The clinical indicators were compared between the two groups.Results The costs of hospitalization in the observation group were less than those in the control group,and the operation time and hospitalization days in the observation group were shorter than those in the control group,and the differences were statistically significant between the two groups(P<0.05).There were no significant differences in the success rate of gallstone removal,the incidence of complications and the recurrence rate between the two groups(P>0.05).ConclusionLC+LCBDE is as safe and effective as ERCP+EST+LC in the treatment of cholecystolithiasis complicated with choledocholithiasis,but LC+LCBDE has shorter hospitalization time and lower hospitalization costs,which can be used as an effective remedial operation after EST fails in the treatment.

关 键 词：内镜十二指肠乳头括约肌切开术 胆囊结石 腹腔镜 胆总管结石 内镜逆行胰胆管造影 

分 类 号：R575.62[医药卫生—消化系统]