腹腔镜下胆总管切开探查术与内镜逆行胆管造影术的临床应用研究  

Clinical research of LCBDE and ERCP in the treatment of recurrent choledocholithiasis after cholecystectomy

作　　者：代俭华 陈光彬 孙礼侠 胡郁之 刘丹峰 DAI Jianhua;CHEN Guangbin;SUN Lixia;HU Yuzhi;LIU Danfeng(Department of Hepatobiliary Surgery,the Second People's Hospital of Wuhu,Wuhu hospital Affiliated to East China Normal University,Wuhu 241001,China)

机构地区：[1]华东师范大学附属芜湖医院(芜湖市第二人民医院)肝胆外科,安徽芜湖241000

出　　处：《包头医学院学报》2022年第4期18-22,共5页Journal of Baotou Medical College

摘　　要：目的:对比分析腹腔镜下胆总管切开探查术(Laparoscopic common bile duct exploration,LCBDE)和内镜逆行胆管造影术(Endoscopic retrograde cholangiopancreatography,ERCP)两种手术方式在胆囊切除术后胆总管再发结石治疗中的疗效及安全性。方法:回顾性分析2018年1月-2020年12月于本院行手术治疗的胆总管再发结石患者78例,其中接受LCBDE组和ERCP组各39例。统计分析两组患者手术时间、结石取净率、住院时间、并发症发生率、随访情况等相关指标的差异。结果:LCBDE组和ERCP组患者在结石取净率(97.4%vs 100%)、手术成功率(97.4%vs 100%)、并发症发生率(10.3%vs 7.7%)方面比较差异无统计学意义(P>0.05);但LCBDE组手术时间(210±69.22)min vs(64.77±20.67)min和术后住院时间(8.22±3.28)d vs(4.87±1.36)d明显长于ERCP组(P<0.05)。结论:LCBDE与ERCP均是治疗胆总管再发结石的安全有效手术方案,ERCP手术时间和住院时间较LCBDE短,值得进一步临床推广应用。Objective:To compare the clinical effects and safety of laparoscopic common bile duct exploration(LCBDE)and endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of recurrent choledocholithiasis after cholecystectomy.Methods:A total of 78 cases of recurrent choledocholithiasis after cholecystectomy treated with LCBDE(n=39)and ERCP(n=39)were retrospectively analyzed.The operating time,disposable stone clearance rate,duration of hospitalization,postoperative complications and follow-up?information were observed and compared between two groups.Results:The two groups were comparable in general conditions.Between LCBDE group and ERCP group,there was no significant difference in terms of the disposable stone clearance rate(97.4%Vs 100%),the success rate(97.4%Vs 100%)and postoperative complications(10.3%Vs 7.7%).However,the operating time(210±69.22min)and duration of hospitalization(8.22±3.28 d)in LCBDE group were longer than those(64.77±20.67min;4.87±1.36d)in ERCP group(P<0.05).Conclusion:Both LCBDE and ERCP are safe and effective for the treatment of recurrent choledocholithiasis after cholecystectomy.As a whole,ERCP is slightly better than LCBDE,both of which are worthy of further clinical promotion and application.

关 键 词：LCBDE ERCP 胆囊切除术 再发胆总管结石 

分 类 号：R65[医药卫生—外科学]