腹腔镜下胆囊切除术联合内镜Oddi括约肌切开取石术治疗CCWC患者的效果  

Effect of Laparoscopic Cholecystectomy Combined with Endoscopic Oddi Sphincterotomy in the Treatment of CCWC Patients

作　　者：林先坚 江小杰[1] 廖常希 陈豪[1] LIN Xianjian;JIANG Xiaojie;LIAO Changxi;CHEN Hao(Putian University Affiliated Hospital,Putian 351100,China;不详)

机构地区：[1]莆田学院附属医院,福建莆田351100

出　　处：《中外医学研究》2022年第28期154-157,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨腹腔镜下胆囊切除术(LC)联合内镜Oddi括约肌切开取石术(EST)治疗胆囊结石合并胆总管结石(CCWC)患者的效果。方法:将莆田学院附属医院2019年12月-2021年12月收治的81例CCWC患者按照随机数字表法分为两组,对照组(40例)给予LC+腹腔镜下胆道探查取石术(LCBDE)治疗,观察组(41例)给予LC+EST治疗,观察两组术后一般状况、血清学指标、生活质量及并发症发生情况。结果:两组术后肛门排气时间比较,差异无统计学意义(P>0.05);观察组下床活动时间早于对照组,住院时间短于对照组,止痛药使用率低于对照组,住院费用高于对照组,差异均有统计学意义(P<0.05);出院当日,观察组碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、总胆红素(TBIL)及直接胆红素水平(DBIL)水平均低于对照组(P<0.05);观察组生活质量综合评定问卷(GQOLI-74)各维度评分均高于对照组(P<0.05);观察组并发症发生率(14.64%)与对照组(20.00%)比较,差异无统计学意义(P>0.05)。结论:LC联合EST治疗CCWC患者可避免结石残留,减少止痛药的使用,促进临床转归,提高生活质量,且不增加并发症发生率,但住院费用较高。Objective:To investigate the effect of laparoscopic cholecystectomy (LC) combined with endoscopic sphincterotomy (EST) of Oddi in the treatment of patients with cholecystolithiasis complicated with choledocholithiasis (CCWC).Method:A total of 81 patients with CCWC who were treated in Putian University Affiliated Hospital from December 2019 to December 2021 were divided into two groups according to the random number table method.The control group (40 cases) was treated with LC + laparoscopic common bile duct exploration (LCBDE),and the observation group (41 cases) was treated with LC+EST treatment,the postoperative general condition,serological indexes,quality of life and complications were observed between the two groups.Result:There was no significant difference in the postoperative anal exhaust time between the two groups (P>0.05).The activity time of getting out of bed in the observation group was earlier than that in the control group,and the time of hospitalization was shorter than that in the control group,the use rate of analgesics was lower than that in the control group,the hospitalization cost was higher than that in the control group,and the differences were statistically significant (P<0.05).On the day of discharge,the levels of alkaline phosphatase (ALP),γ-glutamyl transpeptidase (GGT),total bilirubin (TBIL) and direct bilirubin (DBIL) in the observation group were lower than those in the control group (P<0.05).The scores of generic quality of life inventory-74 (GQOLI-74) dimensions in the observation group were higher than those in the control group (P<0.05).There was no significant difference in the incidence of complications between the observation group (14.64%) and the control group (20.00%) (P>0.05).Conclusion:LC combined with EST in the treatment of CCWC patients can avoid residual stones,reduce the use of analgesics,promote clinical outcomes,improve quality of life,and does not increase the incidence of complications,but the hospitalization costs is high.

关 键 词：胆囊结石合并胆总管结石 腹腔镜下胆囊切除术 内镜Oddi括约肌切开取石术 胆道探查取石术 

分 类 号：R657.4[医药卫生—外科学]