腹腔镜胆总管探查取石术与内镜逆行胰胆管造影联合内镜十二指肠乳头括约肌切开术的近期效果和安全性比较研究  

Comparative study on short-term efficacy and safety of laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography combined with endoscopic duodenal papillary sphincterotomy

作　　者：马东明 顾小晖 Ma Dongming;Gu Xiaohui(Minimally Invasive Department of Hepatobiliary and Pancreatic Surgery,Zhengzhou Central Hospital,Zhengzhou University,Zhengzhou 450007,China;Department of General Surgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学附属郑州中心医院肝胆胰微创外科,郑州450007 [2]郑州大学第二附属医院普通外科,郑州450014

出　　处：《河南外科学杂志》2024年第3期15-17,共3页Henan Journal of Surgery

摘　　要：目的比较分析腹腔镜胆总管探查取石术(LCBDE)与内镜逆行胰胆管造影+乳头括约肌切开术(ERCP+EST)治疗胆总管结石的近期效果和安全性。方法回顾性分析2018-01—2023-05两家医院收治的272例胆总管结石患者的临床资料。按手术方式分为LCBDE组(104例)与ERCP+EST组(168例)。比较2组患者的近期效果及安全性。结果LCBDE组的引流管留置时间长于ERCP+EST组,术中出血量多于ERCP+EST组,差异有统计学意义(P<0.05);但结石一期清除率、住院时间、住院费用,以及术后高淀粉酶血症发生率和总体并发症发生率均优于ERCP+EST组。差异有统计学意义(P<0.05)。结论与ERCP+EST相比,虽然LCBDE术的引流管留置时间更长,术中出血量更多,但其在结石一期清除率、住院时间、住院费用,以及术后并发症发生率方面更具优势。临床应根据有关指征合理选择手术方案。Objective To compare and analyze laparoscopic common bile duct exploration lithotomy(LCBDE)and endoscopic retrograde cholangiopancreatography+endoscopic sphincterotomy(ERCP+EST)for the treatment of choledocholithiasis.Methods A retrospective analysis was performed for the clinical data of patients with choledocholithiasis admitted to the minimally invasive surgery of biliary and pancreatic in Zhengzhou Central Hospital of Zhengzhou University from 2018-01 to 2023-05.According to the surgical method,they were divided into LCBDE group(104 cases)and ERCP+EST group(168 cases).The short-term effect and safety of the two groups were compared.Results The indwelling time of drainage tubes in the LCBDE group was longer than that in the ERCP+EST group,the amount of intraoperative bleeding is more than ERCP+EST group,the difference was statistically significant(P<0.05).The rate of primary stone clearance,the length of hospital stay,the cost of hospitalization,the incidence of postoperative hyperamy lase and the overall complication rate were better than those in the ERCP+EST group,the difference was statistically significant(P<0.05).Conclusion Although the drainage tube indwelling time was longer than that of the ERCP+EST group and the intraoperative blood loss was higher than that of the ERCP+EST group,it had advantages in the first-stage stone clearance rate,hospital stay,hospitalization cost and postoperative complication rate.Clinically the surgical plan should be reasonably selected according to the relevant indications.

关 键 词：胆总管结石 腹腔镜胆总管探查取石术 逆行胰胆管造影 乳头括约肌切开术 

分 类 号：R657.4[医药卫生—外科学]