摘要
目的评价腹腔镜胆囊切除、胆总管探查取石术(LC+LCBDE)与内镜下Oddi括约肌切开联合腹腔镜胆囊切除术(EST+LC)两种术式治疗胆囊结石合并胆总管结石的临床效果。方法胆囊结石合并胆总管结石256例分别采用LC+LCBDE和EST+LC治疗,其中LC+LCBDE术治疗132例、EST+LC术治疗124例,比较两组的并发症发生率、手术总时间、住院费用、住院天数。结果两种术式的近期并发症发生率、结石残留率、平均住院天数比较,差异无统计学意义(P>0.05);EST+LC组手术总时间、手术费用均明显高于LC+CLBDE组(P<0.0l)。结论两种术式各有其适应证和优缺点。胆总管直径<1.0cm、胆总管中下端结石或老年胆石症患者宜采用EST+LC术式;胆总管直径>1.0cm的多发性较大结石、尤其是中青年患者应首选LC+LCBDE术式。
Objective To evaluate the effect of laparoscopic cholecystectomy （ LC ） combined with bile duct exploration and stone removal （BDE） and LC with endoscopic sphincterotomy （EST） in treating cholecystolithiasis with choledocholithiasis. Methods Among 256 cases of cholecystolithiasis and choledocholithlasis, 132 patients were treated by LC ＋ LCBDE, and 124 cases by EST combined with LC. The operation success rate, operation time and cost, complication rate, and length of hospital stay of the two groups were compared. Results There was no statistical difference in the operation success rate, complication rate, stone clearance rate, and average hospital stay between the two groups, but EST ＋ LC group had significantly longer operation time and higher cost. Conclusions There are respective indications, advantages and disadvantages in the two groups. EST ＋ LC is the better choice for patients with diameter of CBD 〈 1.0 cm, stones impacted in the distal CBD, or old age. Otherwise, for patients with diameter of CBD 〉 1.0cm and with multiple choledoeholithiasis, especially for middle-aged patients, the better way is LC ＋ LCBDE.
出处
《中国普通外科杂志》
CAS
CSCD
2008年第6期595-598,共4页
China Journal of General Surgery
关键词
胆囊结石
胆总管结石
胆囊切除术
腹腔镜
胆总管探查
腹腔镜
内镜下乳头括约肌切开术
Cholecystolithiasis
Chotedocholithiasis
Cholecystectomy, Laparoscopic
Common Bile Duct Exploration, Laparoscopic
Endoscopic Sphincterotomy
