ERCP和LCBDE+钬激光碎石分别联合LC治疗胆囊结石合并肝外胆管结石的效果比较  

Comparison of the Efficacy of ERCP and LCBDE+holmium Laser Lithotripsy Combined with LC in the Treatment of Gallstones with Extrahepatic Bile Duct Stones

作　　者：黄子臻 HUANG Zi-zhen(Minimally Invasive Surgery of Hepatobiliary Pancreatic Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学附属郑州市中心医院肝胆胰微创外科,河南郑州450000

出　　处：《罕少疾病杂志》2025年第3期103-105,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 对比在胆囊合并肝外胆管结石的治疗术式中,内镜下逆行胰胆管造影术(ERCP)和腹腔镜胆总管探查取石术(LCBDE)+钬激光碎石分别联合腹腔镜胆囊切除术(LC)的应用效果。方法 按照双色球法对郑州大学附属郑州市中心医院2020年1月至2022年12月收治的胆囊合并肝外胆管结石患者92例进行分组,两组均为46例,且均进行LC,在此基础上,对照组联合ERCP治疗,研究组则联用LCBDE+钬激光碎石治疗,对比两组临床效果。结果 研究组围术期指标和术后恢复情况高于对照组,且术后并发症、疼痛程度(VAS)、结石复发率以及总胆红素(TBIL)与谷丙转氨酶(ALT)水平均低于对照组(P<0.05)。结论 在胆囊合并肝外胆管结石的治疗术式中,相较于ERCP和LC联用,LC和钬激光碎石辅助下的LCBDE治疗不仅能够减轻手术对患者肝胆功能造成的损伤,并改善其围术期表现,还可以减少并发症发生,避免结石复发,加快体征恢复。Objective Compare the application effects of endoscopic retrograde cholangiopancreatography(ERCP)and laparoscopic common bile duct exploration and stone removal(LCBDE)combined with holmium laser lithotripsy(LC)in the treatment of gallbladder combined with extrahepatic bile duct stones.Methods According to the double chromosphere method,92 patients with gallbladder and extrahepatic bile duct stones admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2020 to December 2022 were divided into two groups,with 46 cases in each group,and LC was performed.On this basis,the control group was treated with ERCP in combination,while the study group was treated with LCBDE+holmium laser lithotripsy in combination.The clinical effects of the two groups were compared.Results The perioperative indicators and postoperative recovery of the study group were higher than those of the control group,and the postoperative complications,pain scale(VAS),stone recurrence rate,total bilirubin(TBIL),and alanine aminotransferase(ALT)levels were lower than those of the control group(P<0.05).Conclusion In the treatment of gallbladder combined with extrahepatic bile duct stones,compared with the combination of ERCP and LC,LCBDE treatment assisted by LC and holmium laser lithotripsy can not only reduce the damage to the patient's liver and gallbladder function caused by surgery and improve their perioperative performance,but also reduce the occurrence of complications,avoid stone recurrence,and accelerate the recovery of physical signs.

关 键 词：内镜下逆行胰胆管造影术 腹腔镜胆总管探查取石术 钬激光碎石 腹腔镜胆囊切除术 胆囊结石 肝外胆管结石 

分 类 号：R364.25[医药卫生—病理学]