腹腔镜联合内镜下逆行胰胆管造影术治疗胆囊结石合并胆总管结石的临床疗效  

Clinical Effect of Laparoscopy Combined with Endoscopic Retrograde Cholangiopancreatogra⁃phy in the Treatment of Cholecystolithiasis Complicated with Common Bile Duct Stones

作　　者：张立明 杜磊 ZHANG Liming;DU Lei(Department of General Surgery,Xuzhou Medical University Affiliated Pizhou Hospital(Pizhou People's Hospital),Pizhou 221300,Jiangsu,China)

机构地区：[1]徐州医科大学附属邳州医院(邳州市人民医院)普通外科,江苏邳州221300

出　　处：《世界复合医学(中英文)》2025年第2期117-120,共4页World Journal of Complex Medicine

摘　　要：目的探讨胆囊结石合并胆总管结石(common bile duct stones,CBDS)患者采取腹腔镜联合内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)治疗的临床疗效。方法选取2021年8月—2023年8月徐州医科大学附属邳州医院收治的胆囊结石合并CBDS患者88例,按照治疗方法的不同分为对照组(n=44,开腹胆囊切除术联合胆总管切开取石T管引流术)和观察组[n=44,腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合ERCP术]。比较两组术中指标、术后恢复指标、结石残留率、并发症总发生率。结果相比于对照组,观察组术中出血量更少,切口长度、排气时间、住院时间均更短,差异均有统计学意义(P均<0.05)。并发症总发生率比较,观察组为4.55%(2/44),对照组为20.45%(9/44),差异有统计学意义(χ^(2)=5.091,P=0.024)。手术时间及结石残留率两组比较,差异均无统计学意义(P均>0.05)。结论临床胆囊结石合并CBDS患者采取LC联合ERCP治疗可改善的术后恢复指标,减少并发症的发生。Objective On patients with cholecystolithiasis with common bile duct stones(CBDS)treated with laparoscopy combined with endoscopic retrograde cholangiopancreatography(ERCP)of the clinical curative effect.Methods A total of 88 patients with cholecystolithiasis complicated with CBDS admitted to Xuzhou Medical University Affiliated Pizhou Hospital from August 2021 to August 2023 were selected.According to different treatment methods,they were divided into control group(n=44,open cholecystectomy combined with choledochotomy and T-tube drainage)and observation group[n=44,laparoscopic cholecystectomy(LC)combined with ERCP].The intraoperative indexes,postoperative recovery indexes,stone residual rate and total complication rate were compared between the two groups.Results Compared with the control group,the observation group had less intraoperative blood loss,shorter incision length,exhaust time and hospital stay,the differences were statistically significant(all P<0.05).The total incidence of complications was 4.55%(2/44)in the observation group and 20.45%(9/44)in the control group,and the difference was statistically significant(χ^(2)=5.091,P=0.024).There were no significant differences in operation time and residual stone rate between the two groups(both P>0.05).Conclusion In clinical patients with cholecystolithiasis complicated with CBDS,LC combined with ERCP can improve postoperative recovery indicators and reduce the occurrence of complications.

关 键 词：胆囊结石 胆总管结石 腹腔镜手术 开腹手术 内镜下逆行胰胆管造影手术 结石残留率 

分 类 号：R657.4[医药卫生—外科学]