Clinical observation of laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography or common bile duct lithotripsy  

作　　者：Hong Niu Fei Liu Yi-Bo Tian 

机构地区：[1]Department of Gastroenterology,Jincheng General Hospital,Jincheng 048000,Shanxi Province,China [2]Department of General Surgery,Jincheng General Hospital,Jincheng 048000,Shanxi Province,China [3]Department of Emergency,Jincheng General Hospital,Jincheng 048000,Shanxi Province,China

出　　处：《World Journal of Clinical Cases》2022年第30期10931-10938,共8页世界临床病例杂志

摘　　要：BACKGROUND The incidence of common bile duct(CBD) stones accounts for approximately 10%–15% of all CBD diseases.Approximately 8%–20% of these patients also have gallstones with heterogenous signs and symptoms.AIM To investigate the clinical effects of laparoscopic cholecystectomy(LC) combined with endoscopic retrograde cholangiopancreatography(ERCP) and LC with CBD excision and stone extraction in one-stage suture(LBEPS) for the treatment of gallbladder and CBD stones.METHODS Ninety-four patients with gallbladder and CBD stones were selected from our hospital from January 2018 to June 2021.They were randomly divided into study and control groups with 47 patients each.The study group underwent LC with ERCP,and the control group underwent LC with LBEPS.Surgery,recovery time of gastrointestinal function,complication rates,liver function indexes,and stress response indexes were measured pre-and postoperatively in both the groups.RESULTS The durations of treatment and hospital stay were shorter in the study group than in the control group.There was no significant difference between the one-time stone removal rate between the study and control groups.The time to anal evacuation,resumption of oral feeding,time to bowel sound recovery,and time to defecation were shorter in the study group than in the control group.The preoperative serum direct bilirubin(DBIL),total bilirubin(TBIL),and alanine aminotransferase(ALT) levels were insignificantly higher in the study group than that in the control group.A day after surgery,the postoperative serum DBIL,TBIL,and ALT levels were lower than their preoperative levels in both groups,and of the two groups,the levels were lower in the study group.Although the preoperative serum adrenocorticotrophic(ACTH),cortisol(COR),epinephrine(A),and norepinephrine(NE) levels were higher in the study group than that in the control group,these differences were not significant(P > 0.05).The serum ACTH,COR,A,and NE levels in both groups decreased one day after surgery compared to the preoperative

关 键 词：Laparoscopic cholecystectomy Endoscopic retrograde cholangiopancreatography Choledochotomy with one-stage suture Gallbladder stones Common bile duct stones 

分 类 号：R657.4[医药卫生—外科学]