LC联合ERCP一期治疗胆囊结石合并肝外胆管结石与分期ERCP+LC手术疗效比较  

Comparison of surgical efficiency of laparoscopic cholecystectomy and ERCP in treatment of cholecystolithiasis and choledocholithiasis between one stage approach and two stage procedure

作　　者：胡刚峰 黄侠 HU Gangfeng;HUANG Xia(Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Chongming Branch,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院普外科,上海202150

出　　处：《外科理论与实践》2021年第5期437-440,共4页Journal of Surgery Concepts & Practice

基　　金：上海市崇明区“可持续发展科技创新行动计划”(CKY2019-16)。

摘　　要：目的:探讨比较腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)一期治疗胆囊结石合并肝外胆管结石与分期手术的临床疗效。方法:本院2018年4月至2020年4月期间收治的191例胆囊结石合并肝外胆管结石的病人分为两组,98例行LC联合一期ERCP取石(研究组);93例行ERCP取石+择期LC(对照组)。比较两组的手术时间、术中出血量、术后住院时间、手术成功率、并发症发生以及住院费用。结果:与对照组相比,研究组手术时间、术后住院时间、住院费用均明显降低(P<0.05),术中出血量、手术成功率和术后并发症发生率差异无统计学意义(P>0.05)。结论:LC联合ERCP取石一期治疗胆囊结石合并肝外胆管结石安全可行,具有手术时间短、术后住院时间短、住院费用低的优点。Objective To explore the clinical effect of laparoscopic cholecystectomy(LC)combined with endoscopic retrograde cholangiopancreatography(ERCP)in treatment of cholecystolithiasis combined with choledolithiasis in one stage approach compared with two stage procedure.Methods A total of 191 patients with cholecystolithiasis and choledo-cholithiasis admitted to our hospital from April 2018 to April 2020 were divided into two groups.Ninty-eight patients were treated with LC and ERCP in one stage approach(study group)and 93 patients in two stage procedure(control group).Operative time,bleeding loss,postoperative length of hospital stay,success rate,complication and hospital cost were com-pared between two groups.Results Compared with two stage procedure in control group,operative time,postoperative length of hospital stay and hospital cost(P<0.05)reduced significantly in one stage approach(study group),and there was no significant difference between two groups in bleeding loss,success rate,and postoperative complications(P>0.05).Conclusions LC with ERCP in one stage approach would be safe and feasible for the patients of cholecystolithiasis and choledolithiasis with advantages of short both operative time and hospital stay and low cost.

关 键 词：胆囊结石 肝外胆管结石 腹腔镜胆囊切除术 内镜逆行胰胆管造影 

分 类 号：R657.42[医药卫生—外科学]