腹腔镜胆囊切除术联合胆道探查取石与内镜下Oddi括约肌切开取石联合腹腔镜胆囊切除治疗胆囊结石合并胆总管结石的临床疗效  

Clinical efficacy of laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration and endoscopic sphincterotomy of Oddi combined with laparoscopic cholecystectomy in the treatment of cholecystolithiasis combined with common bile duct stones

作　　者：马建春 尹小波 苏红彬 金荣生 MA Jianchun;YIN Xiaobo;SU Hongbin;JIN Rongsheng(Department of General Surgery,the Fourth People's Hospital of Rugao City,Rugao,Jiangsu,226511,China)

机构地区：[1]如皋市第四人民医院普外科,江苏如皋226511

出　　处：《当代医学》2022年第27期171-174,共4页Contemporary Medicine

摘　　要：目的探究腹腔镜胆囊切除术(LC)联合胆道探查取石(LCBDE)与内镜下Oddi括约肌切开(EST)取石联合LC治疗胆囊结石合并胆总管结石的疗效。方法选取2019年6月至2020年6月本院收治的90例胆囊结石合并胆总管结石患者作为研究对象,按照治疗方式不同分为观察组与对照组,每组45例。观察组采用LC+LCBDE治疗,对照组采用EST+LC治疗,比较两组手术情况与并发症发生情况及治疗后生命质量。结果观察组一次手术成功率为97.78%,高于对照组的84.44%,差异有统计学意义(P<0.05);观察组住院时间短于对照组,住院费用少于对照组,差异有统计学意义(P<0.05);两组手术时间、出血量及并发症发生率比较差异无统计学意义。观察组生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康评分均高于对照组,差异有统计学意义(P<0.05)。结论LCBDE+LC治疗胆囊结石合并胆总管结石效果优于EST+LC方式,可提高一次手术成功率,缩短住院时间,减少住院费用,提高患者生命质量,值得临床推广应用。Objective To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with laparoscopic common bile duct exploration(LCBDE)and endoscopic sphincterotomy(EST)of Oddi combined with LC in the treatment of cholecystolithiasis combined with common bile duct stones.Methods 90 patients with cholecystolithiasis combined with common bile duct stones admitted to our hospital from June 2019 to June 2020 were selected as the research subjects,and they were divided into observation group and control group according to different treatment methods,with 45 cases in each group.The observation group was treated with LC+LCBDE,and the control group was treated with EST+LC,the incidence of operation and complications and quality of life after treatment were compared between the two groups.Results The success rate of one operation in the observation group was 97.78%,which was higher than 84.44%in the control group,and the difference was statistically significant(P<0.05);the hospitalization time in the observation group was shorter than that in the control group,and the hospitalization expenses were less than that in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in operation time,blood loss and complication rate between the two groups.The scores of physiological function,physiological function,body pain,general health,energy,social function,emotional function,and mental health in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion LCBDE+LC is better than EST+LC in the treatment of cholecystolithiasis combined with common bile duct stones,can improve the success rate of one operation,shorten the hospitalization time,reduce the hospitalization expenses,and improve the quality of life of patients,which is worthy of clinical application.

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

分 类 号：R657.4[医药卫生—外科学]