摘要
目的:探讨腹腔镜二次手术与经内镜逆行性胰胆管造影术(endoscopic retrograde cholang iopancreatography,ERCP)治疗胆总管再发结石的疗效评估.方法:选取2007-01/2013-01 1372例行胆总管结石切开取石患者,其中符合标准的单纯胆总管再发结石68例,35例行腹腔镜手术,33例行ERCP术,观察患者术后肝功能,住院时间、费用等,同时评估并发症发生情况.结果:两组患者术后2 w k肝功能指标率(P>0.05)、住院费用(t=1.515,P=0.135)、手术时间(t=1.923,P=0.059)、胃肠道功能恢复时间(t=1.807,P=0.075)差异均无统计学意义;腹腔镜组与ERCP组相比,住院时间明显延长,比较差异有统计学意义(t=3.929,P<0.001);腹腔镜手术组术后并发症发生率明显低于ERCP组(P=0.025).结论:对于单纯胆总管再发结石患者,腹腔镜行二次手术和ERCP相比更为合理,而ERCP治疗胆总管再发结石的手术指征需要进一步探讨.
AIM： To compare the curative effects of a second laparoscopic surgery with endoscopic retrograde cholangiopancreatography（ERCP） in the treatment of recurrence of common bile duct stones. METHODS： A total of 1372 patients who underwent laparoscopic choledocholithotomy from 2007 to 2013 atourhospital were included in this study. Among them, 68 had recurrent common bile duct stones, of whom 35 underwent a second laparoscopic surgery and 33 received ERCP. The patients were observed for their postoperative liver function, length of hospital stay, and hospitalization expense, and the complications were also assessed. RESULTS ： There were no significant differences between the two groups in liver function at 2 wk postoperatively（P 〉 0.05）, hospitalization expenses（t = 1.515, P = 0.135）, operation duration（t = 1.923, P = 0.059） and time to recovery of gastrointestinal function（t = 1.807, P = 0.075）. Compared with the ERCP group, the laparoscopic surgery group had significantly longer hospitalization time（t = 3.929, P 〈 0.001） and a significantly lower rate of complications（P = 0.025）. No serious complication was seen in the laparoscope surgery group, but 3 cases appeared in the ERCP group. CONCLUSION： For patients with simple recurrent common bile duct stones, a second laparoscopic surgery is more reasonable than ERCP.
出处
《世界华人消化杂志》
CAS
2015年第11期1834-1839,共6页
World Chinese Journal of Digestology
