| 宋德静,安东,施开德,丁振,王向阳,蒋维维.腹腔镜同步和内镜-腹腔镜序贯手术治疗胆囊结石合并胆总管结石的疗效观察[J].中国临床保健杂志,2017,20(4):385-388. |
| 腹腔镜同步和内镜-腹腔镜序贯手术治疗胆囊结石合并胆总管结石的疗效观察 |
| The efficacy comparison of laparoscopic and endoscopic sequential laparoscopic surgery in the treatment of cholecystolithiasis combined with choledocholithiasis |
| 投稿时间：2016-12-01 |
| DOI：10.3969/J.issn.1672-6790.2017.04.015 |
| 中文关键词: 胆石 腹腔镜检查 胆道外科手术 |
| 英文关键词: Cholelithiasis Laparoscopy Biliary tract surgical procedures 〖FL |
| 基金项目:国家自然科学基金(81100318) |
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| 中文摘要: |
| 目的 对比分析腹腔镜胆囊切除术联合腹腔镜胆总管探查(LC-LCBDE同步)和内镜下十二指肠乳头括约肌切开取石联合腹腔镜胆囊切除术(EST-LC序贯)治疗胆囊结石合并胆总管结石的疗效,旨在为该疾病的临床治疗选择合理的方式。方法 回顾性分析采用LC-LCBDE同步治疗及40例采用EST-LC序贯治疗的胆囊结石合并胆总管结石病例资料(共80例)。结果 两组均无死亡病例,LC-LCBDE组37例完成手术,3例中转开腹,EST-LC组36例完成序贯治疗手术,4例因内镜下插管失败改行LC-LCBDE。两组手术成功率,手术时间,一次性结石清除率,总并发症相比,差异无统计学意义(P>0.05),住院时间和住院费用方面比较,LC-LCBDE组优于EST-LC组,差异有统计学意义[(10.20±1.23) d比(13.50±2.41) d,t=3.006,P=0.004;(1.93±0.21)万元比(2.67±0.34)万元,t=3.132,P=0.003]。结论 在胆囊结石合并胆总管结石的微创治疗中,LC-LCBDE同步治疗在住院时间及住院费用方面优于EST-LC序贯治疗,在技术条件允许下应列为首选。在胆总管相对较细(<0.8 cm),结石位置较低直径较小,可以选择EST-LC序贯治疗。 |
| 英文摘要: |
| Objective To compare laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE,LC-LCBDE) and endoscopic sphincterotomy (EST) combined with LC (EST-LC sequential) curative effect in the treatment of cholecystolithiasis combined with choledocholithiasis.Methods The clinical data of 80 cases of cholecystolithiasis combined with choledocholithiasis were analyzed retrospectively,40 cases were treated with LC-LCBDE,the other 40 cases were treated with EST-LC sequential therapy.Results The two groups were no deaths,37 cases in LC-LCBDE group completed the surgery,3 cases were converted to laparotomy,36 cases in EST-LC group completed the sequential therapy of surgery,4 cases by endoscopic intubation failed received LC-LCBDE,two surgical success rate,operation time,one-time stone clearance rate,total complications compared,no significant difference (P>0.05).The hospitalization time and cost were statistically significant between LC-LCBDE and EST-LC groups (P<0.05).Conclusion In the minimally invasive treatment of cholecystolithiasis combined with choledocholithiasis,LC-LCBDE synchronization therapy is superior to EST-LC sequential therapy in hospital stay and hospitalization cost,and thus should be listed as the first choice under the technical condition.For the common bile duct being relatively thinner (<0.8cm),the location lower,the stones smaller,EST-LC sequential therapy may be chosen. |
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