三步法EST联合腹腔镜手术治疗胆囊结石合并胆总管结石的效果分析  

Effect of the Three-stage EST Method in Combination with Laparoscopic Surgery on Gallbladder Stones in Combination with Common Bile Duct Stones

作　　者：佘明豪 杨文辉 余洋 夏超 SHE Ming-hao;YANG Wen-hui;YU Yang;XIA Chao(Department of General Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan Province,China;Department of Gastroenterology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan Province,China)

机构地区：[1]郑州大学附属郑州中心医院普通外科,河南郑州450007 [2]郑州大学附属郑州中心医院消化内科,河南郑州450007

出　　处：《罕少疾病杂志》2022年第11期56-57,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的分析三步法括约肌切开取石术(EST)联合腹腔镜胆囊切除术(LC)治疗胆囊结石合并胆总管结石的效果。方法选取2019年8月至2021年8月我院胆囊结石合并胆总管结石患者106例,随机分为A组(n=53)和B组(n=53),B组予以传统开腹手术治疗,A组予以EST联合LC治疗。比较2组疗效、围术期情况、血清因子及并发症。结果A组取石成功率98.11%(52/53)与B组90.57%(48/53)对比,无显著差异(P>0.05);A组术中出血量、住院费用均较B组少,下床时间、排气时间、住院时间均较B组短(P<0.05);术后,A组C反应蛋白(CRP)水平较B组低(P<0.05),谷草转氨酶(AST)、总胆红素(TBIL)水平与B组对比,无显著差异(P>0.05);A组并发症发生率5.66%(3/53)较B组20.75%(11/53)低(P<0.05)。结论EST联合LC治疗胆囊结石合并胆总管结石患者,可提高取石成功率,可减少患者术中出血量,调节血清因子表达,促进预后。Objective analysis of the effect of a three-stage sphincterolithotomy(EST)combined with a laparoscopic cholecystectomy(LC)in the treatment of gallbladder stones with common bile duct stones.Methods From August 2019 to August 2021,106 patients with gallbladder stones and common bile duct stones in our hospital were selected and randomly assigned to Group A(n=53)and Group B(n=53).Group B was treated with traditional open surgery and Group A was treated with EST combined with LC.Efficacy,perioperative condition,serum factor levels,and complications were compared between the two groups.Results The stone removal success rate was 98.11%(52/53)in Group A and 90.57%(48/53)in Group B with no significant difference(P>0.05);Intraoperative bleeding and hospital costs in Group A were less than in Group B,and time to get out of bed,evacuation time,and hospital stay were shorter than in Group B(P<0.05);After surgery,C-reactive protein(CRP)levels were lower in group A than in group B(P<0.05),and levels of aspartate aminotransferase(AST)and total bilirubin(TBIL)were not significantly different from those in Group B(P>0.05).The incidence of complications in Group A was 5.66%(3/53)lower than in Group B at 20.75%(11/53)(P<0.05).Conclusion EST combined with LC in patients with gallbladder stones and common bile duct stones has a good success rate in stone removal,which can reduce the extent of intraoperative bleeding,regulate expression of serum factors,reduce complications and accelerate postoperative rehabilitation.

关 键 词：括约肌切开取石术 胆囊结石 胆总管结石 腹腔镜胆囊切除术 

分 类 号：R575.7[医药卫生—消化系统]