LCBDE和ERCP+EST治疗胆囊结石合并胆总管结石的疗效观察  

Curative effect of LCBDE and ERCP+EST on cholecystolithiasis combined with choledocholithiasis

作　　者：陈燕[1] Chen Yan(Department of Hepatobiliary and Pancreatic Surgery,The First People's Hospital of Liangshan Yi Autonomous Prefecture,Xichang Sichuan Province 615000,China)

机构地区：[1]凉山彝族自治州第一人民医院肝胆胰外科,四川西昌615000

出　　处：《中华普外科手术学杂志（电子版）》2024年第4期385-388,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省科技计划项目(2021JDR0341)。

摘　　要：目的探讨腹腔镜下胆总管切开取石术(LCBDE)和内镜逆行胰胆管造影+十二指肠乳头切开取石术(ERCP+EST)治疗胆囊结石合并胆总管结石的疗效。方法回顾性分析2021年2月至2023年2月116例胆囊结石合并胆总管结石的患者临床资料,按手术方式不同分为A组(n=61例,行LCBDE)和B组(n=55例,行ERCP+EST)。数据统计处理及分析采用SPSS22.0软件,围手术期参数、住院情况等计量资料以(x±s)表示,采用独立样本t检验;并发症发生率、结石残余率、结石复发率等计数资料以[例(%)]表示,采用x^(2)检验。P<0.05为差异有统计学意义。结果A组患者术中出血量多于B组,手术时间长于B组,住院时间、住院费用少于B组,术后胰腺炎发生率、结石残余率低于B组,上述指标组间差异均有统计学意义(P<0.05)。结论较ERCP+EST,LCBDE治疗胆囊结石合并胆总管结石在减轻患者经济负担、减少术后胰腺炎发生及结石残留方面更有优势,但术中出血量更多、手术时间更长。Objective To investigate the efficacy of laparoscopic choledocholithotomy(LCBDE)and endoscopic retrograde cholangiopancreatography plus duodenal papillectomy(ERCP+EST)in the treatment of cholecystolithiasis combined with choledocholithiasis.Methods The clinical data of 116 patients with cholecystolithiasis combined with choledocholithiasis from February 2021 to February 2023 were retrospectively analyzed and divided into group A(n=61 cases,LCBDE)and group B(n=55 cases,ERCP+EST)according to different surgical methods.SPSS 22.O software was used for statistical processing and analysis of data.Measurement data such as perioperative parameters and hospitalization were expressed as(x±s),and independent sample t test was used.The statistical data of complication rate,stone residual rate and stone recurrence rate were shown as[cases(%)]and x^(2) test was used.P<0.05 was considered statistically significant.ResultsT The intraoperative blood loss in group A was more than that in group B,the operation time was longer,the hospitalization time and hospitalization cost were less than those in group B,and the incidence of postoperative pancreatitis and stone residual rate were lower than those in group B,with statistical significance among the above indicators(P<0.05).Conclusion Compared with ERCP+EST,LCBDE in the treatment of cholecystolithiasis combined with choledocholithiasis has more advantages in reducing the economic burden of patients,reducing the occurrence of postoperative pancreatitis and stone residue,but it has more intraoperative blood loss and longer operation time.

关 键 词：胆囊结石病 胆总管结石病 胰胆管造影术 内窥镜逆行 腹腔镜 胆总管切开取石术 

分 类 号：R657.4[医药卫生—外科学]