ERCP/EST联合LC微创治疗胆囊结石合并胆总管结石的临床应用  

Clinical application of the treatment of choledocholithiasis combined with cholecystolithiasis by ERCP/EST combined LC

作　　者：王学新[1] 聂晓辉[1] 凌传江[1] 郭新文 胡德军[1] 马文颖 WANG Xue-xin;NIE Xiao-hui;LING Chuan-jiang(The Department of Emergency Surgery,The First People’s Hospital of Akesu city,Akesu 843000,China)

机构地区：[1]阿克苏地区第一人民医院急诊外科,阿克苏843000 [2]阿克苏地区第一人民医院消化内科

出　　处：《肝胆外科杂志》2023年第2期113-115,共3页Journal of Hepatobiliary Surgery

摘　　要：目的探讨经内镜逆行性胰胆管造影术(ERCP)/经十二指肠镜Oddi括约肌切开术(EST)联合LC治疗胆囊结石合并胆总管结石的临床疗效和手术时机选择。方法选取我科2020年6月至2022年10月收治的胆囊结石合并胆总管结石的患者38例,所有患者均先行ERCP/EST取石,胆总管无结石残留,病情稳定,术后1~5天行LC,1例术后1周LC。结果ERCP/EST术后部分患者感腹胀、恶心呕吐,6例出现高淀粉酶血症,1例并发胰腺炎,LC术中中转2例,所有患者无损伤、出血、胆漏等并发症。结论ERCP/EST联合LC治疗胆囊结石合并胆总管结石具有创伤小、恢复快、瘢痕小、无需放置T管等,值得临床应用。Objective To investigate the clinical efficacy and timing of endoscopic retrograde cholangiopancreatography(ER-CP)/transduodenoscopicOddisphincterotomy(EST)combined with LC in the treatment of cholecystolithiasis combined with choledo-cholithiasis.Methods A total of 38 patients with cholecystolithiasis combined with choledocholithiasis admitted to our department from June 2020 to October 2022 were selected.All patients underwent ERCP/EST lithotomy first,without residual choledocholithiasis,and their condition was stable.LC was performed 1~5 days after surgery,and 1 patient underwent LC 1 week after surgery.Results After ERCP/EST,some patients felt abdominal distension,nausea,vomiting,hyperamylasemia in 6 cases,pancreatitis in 1 case,and LC transfer in 2 cases,all patients had no injury,bleeding,bile leakage and other complications.Conclusion ERCP/EST com-bined LC in the treatment of cholecystolithiasis combined with choledocholithiasis has the advantages of less trauma,faster recovery,less scar,no need to place T tube,etc.,which is worthy of clinical application.

关 键 词：胆囊结石 胆总管结石 ERCP/EST LC 

分 类 号：R657.3[医药卫生—外科学]