期刊文献+

LC术前及术后ERCP+EST治疗胆囊结石合并胆总管结石的效果比较 被引量:6

Efficacy comparison of ERCP plus EST before and after laparoscopic cholecystectomy in the treatment of cholelithiasis complicated with choledocholithiasis
下载PDF
导出
摘要 目的探讨和比较腹腔镜胆囊切除术(LC)术前行经内镜逆行性胰胆管造影术(ERCP)和内镜下括约肌切开术(EST)与LC术后行ERCP和EST治疗胆囊结石合并胆总管结石的效果。方法选取2009年9月-2012年12月在山西医科大学第一附属医院及太钢总医院人院的胆囊结石合并胆总管结石行LC及ERCP+EST的患者69例,其中LC术前行ERCP+EST39例,LC术后行ERCP+EST30例,比较两组的住院时间、并发症发生率、相关指标变化情况。结果术前组的住院时间短于术后组,差异有统计学意义(P〈0.05)。术前组的发热、急性胰腺炎发生率均低于术后组,差异有统计学意义(P〈0.05);两组的出血、穿孔发生率比较差异无统计学意义(P〉0.05)。术前组的白细胞升高、高淀粉酶血症发生率均低于术后组,差异有统计学意义(P〈0.05);两组的总胆红素值下降、ALT值下降发生率比较差异无统计学意义(P〉0.05)。结论LC术前行ERCP+EST具有并发症少、住院时间短等优点,对治疗胆囊结石合并胆总管结石具有广阔的应用前景,值得临床推广应用。 Objective To explore and compare the efficacy of endoscopic retrograde cholangiopancreatography(ERCP) plus endoscopic sphincterotomy(EST)before and after laparoscopie cholecystectomy(LC)in the treatment of eholelithiasis complicated with choledocholithiasis. Methods 69 cases of patients with eholelithiasis complicated with choledoeholithiasis in the First Affiliated Hospital of Shanxi Medical University and the General Hospital of TISCO from September 2009 to December 2012 were selected and received LC and ERCP plus EST.39 patients received ERCP plus EST before LC and 30 patients received ERCP plus EST after LC.Hospitalization time,incidence rate of complication and the relevant index change in two groups was compared respectively. Results Hospitalization time in preoperative group was shorter than that in postoperative group,with statistical difference (P〈0.05).The incidence rate of fever and acute panereatitis in preoperative group was lower than that in postoperative group respectively,with statistical difference(P〈O.O5).The incidence rate of bleeding and perforation in two groups was compared respectively,with no statistical difference(P〉0.05).The incidence rate of increase leukocytes and hyperamylasemia in preoperative group was lower than that in postoperative group respectively,with statistical difference(P〈0.05).The incidence rate of total bilirubin value falls and ALT value decline in two groups was compared respectively,with no statistical difference (P〉0.05). Conclusion ERCP plus EST carried out before LC has advantages of less complication and shorter hospitalization time,and has a wide prospect of application in the treatment of cholelithiasis complicated with choledoeholithiasis,which is worthy of clinical promotion and application.
出处 《中国当代医药》 2014年第17期52-54,57,共4页 China Modern Medicine
关键词 腹腔镜胆囊切除术 经内镜逆行性胰胆管造影术 内镜下括约肌切开术 胆囊结石 胆总管结石 Laparoscopic eholecystectomy Endoscopic retrograde cholangio-pancreatography Endoscopic sphinctero- tomy Cholelithiasis Choledocholithiasis
  • 相关文献

参考文献13

二级参考文献55

共引文献241

同被引文献67

  • 1李春生,王勇,邹奇,刘进军,闵志钧.80岁以上老年急性重症胆管炎的个体化治疗体会[J].实用老年医学,2013,27(3):251-253. 被引量:7
  • 2Bruno Rosa,Pedro Moutinho Ribeiro,Ana Rebelo,António Pinto Correia,José Cotter.Endoscopic papillary balloon dilation after sphincterotomy for difficult choledocholithiasis:A case-controlled study[J].World Journal of Gastrointestinal Endoscopy,2013,5(5):211-218. 被引量:22
  • 3Yun-Sheng Qin, Qi-Yong Li, Fu-Chun Yang , Shu-Sen Zheng Division of Hepatobiliary and Pancreatic Surgery,Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health,Key Laboratory of Organ Transplantation Zhejiang Province, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.Risk factors and incidence of acute pyogenic cholangitis[J].Hepatobiliary & Pancreatic Diseases International,2012,11(6):650-654. 被引量:21
  • 4陈文军,雷万福,徐福祥.老年胆道疾病139例手术分析[J].实用老年医学,2006,20(3):204-205. 被引量:4
  • 5Melissa Phillips,Jeffrey Marks,Kurt Roberts,Roberto Tacchino,Raymond Onders,George DeNoto,Homero Rivas,Arsalla Islam,Nathaniel Soper,Gary Gecelter,Eugene Rubach,Paraskevas Paraskeva,Sajani Shah.Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy[J].Surgical Endoscopy.2012(5)
  • 6Jan Siert K. Reinders,Annemarie Goud,Robin Timmer,Philip M. Kruyt,Ben J.M. Witteman,Niels Smakman,Ronald Breumelhof,Sandra C. Donkervoort,Jeroen M. Jansen,Joos Heisterkamp,Marina Grubben,Bert van Ramshorst,Djamila Boerma.Early Laparoscopic Cholecystectomy Improves Outcomes After Endoscopic Sphincterotomy for Choledochocystolithiasis[J].Gastroenterology.2010(7)
  • 7Leopoldo Sarli,Domenico R. Iusco,Luigi Roncoroni.??Preoperative Endoscopic Sphincterotomy and Laparoscopic Cholecystectomy for the Management of Cholecystocholedocholithiasis: 10-Year Experience(J)World Journal of Surgery . 2003 (2)
  • 8Albrecht R,Franke K,Koch H,Saeger HD.Prospective Evaluation of Risk Factors Concerning Intraoperative Conversion from Laparoscopic to Open Cholecystectomy. Zentralblatt fur Chirurgie . 2013
  • 9Wang B,Liu Z,LüY,Zhao S,Chen L.A meta-analysis of preoperative versus intraoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones. Chinese Medical Journal . 2015
  • 10Gurusamy KS,Koti R,Samraj K,Davidson BR.T-tube drainage versus primary closure after open common bile duct stone exploration. Cochrane Database of Systematic Reviews . 2013

引证文献6

二级引证文献58

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部