两种微创术式治疗胆囊结石合并胆总管结石的效果比较  

Comparison of the effects between two minimally invasive treatments on cholecystolithiasis complicated with choledocholithiasis

作　　者：黄强松 胡福境 黄海 HUANG Qiang-song;HU Fu-jing;HUANG Hai(Department of Hepatobiliary Surgery, Wuming Hospital of Guangxi Medical University, Nanning 530100, China)

机构地区：[1]广西医科大学附属武鸣医院肝胆外科,南宁530100 [2]广西医科大学附属武鸣医院消化内科,南宁530100

出　　处：《中国临床新医学》2022年第2期110-113,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的比较腹腔镜下胆囊切除术(LC)联合内窥镜逆行胰胆管造影术(ERCP)与LC联合腹腔镜下胆总管切开取石术(LCBDE)治疗胆囊结石合并胆总管结石的效果。方法回顾性收集2019年1月至2021年12月广西医科大学附属武鸣医院收治的64例胆囊结石合并胆总管结石患者,其中按计划筛选出接受LC+LCBDE(LCBDE组)患者32例,接受LC+ERCP(ERCP组)患者32例。比较两组患者相关临床指标。结果ERCP组的手术时间(3.0±1.0)d,短于LCBDE组的(4.7±1.4)d;术后住院时间(5.3±2.0)d,短于LCBDE组的(13.1±4.7)d;住院费用低于LCBDE组,差异均有统计学意义(均P<0.05)。结论LC+LCBDE和LC+ERCP均为治疗胆囊结石合并胆总管结石有效且安全的治疗方式,但LC+ERCP更能缩短手术时间和住院时间,减少住院费用,在适应证下,可作为首选治疗方式。Objective To compare the effects between laparoscopic cholecystectomy(LC)combined with endoscopic retrograde cholangiopancreatography(ERCP)and LC combined with laparoscopic common bile duct exploration(LCBDE)on the treatment of cholecystolithiasis complicated with choledocholithiasis.Methods Sixty-four patients with cholecystolithiasis complicated with choledocholithiasis who were admitted to Wuming Hospital of Guangxi Medical University from January 2019 to December 2021 were retrospectively collected.Among the 64 patients,32 cases receiving LC+LCBDE(LCBDE group)and 32 cases receiving LC+ERCP(ERCP group)were screened out according to the plan.The clinical indicators were compared between the two groups.Results The operation time in the ERCP group[(3.0±1.0)d]was shorter than that in the LCBDE group[(4.7±1.4)d],and the postoperative hospitalization time in the ERCP group[(5.3±2.0)d]was shorter than that in the LCBDE group[(13.1±4.7)d],and the hospitalization costs in the ERCP group were lower than those in the LCBDE group,and the differences were statistically significant(P<0.05).Conclusion LC+LCBDE and LC+ERCP are both effective and safe methods for the treatment of cholecystolithiasis complicated with choledocholithiasis,but LC+ERCP can shorten the operation time and the hospitalization time,and reduce the hospitalization costs compared with LC+LCBDE.For the indications,LC+ERCP can be used as the preferred treatment method.

关 键 词：胆囊结石 胆总管结石 内窥镜逆行胰胆管造影术 腹腔镜下胆总管切开取石术 

分 类 号：R657.4[医药卫生—外科学]