摘要
目的：比较腹腔镜胆囊切除术联合腹腔镜胆总管切开取石（LCBDE）与内镜下括约肌切开取石术联合腹腔镜胆囊切除术（ERCP／S ＋LC）治疗胆囊结石合并胆总管结石的疗效。方法回顾性分析280例胆囊结石合并胆总管结石患者的资料，根据治疗方案分为 LCBDE 组（A 组60例）和 ERCP／S ＋LC 组（B 组220例）。比较两种治疗方法的疗效。结果A、B 两组手术用时、术后住院时间、住院费用、胆总管结石大小、结石清除率、术后并发症发生率分别为（95．58±22．66）min、（87．46±40．25）min、（15．18±5．46）d、（14．32±4.21）d、（2．45±0．32）万元、（2．89±0．64）万元，（1．12±0．34）cm、（1．39±0．38）cm、96．6％、91．0％，1．6％、3．2％。两组手术结石清除率差异无统计学意义（χ^2＝1．44，P ＞0．05），LCBDE 组的住院费用略低于 ERCP／S＋LC 组，但差异无统计学意义（t ＝0．923，P ＞0．05）。ERCP／S ＋LC 组术后并发症发生率要高于 LCBDE 组，差异有统计学意义（χ^2＝4．17，P ＜0．05）。结论LCBDE 和 ERCP／S ＋LC 均是治疗胆囊结石合并胆总管结石的有效微创疗法，在临床上应根据患者实际情况选择使用。
Objective To compare the effect of endoscopic retrograde cholangiopancreatography sphincterot-omy plus laparoscopic cholecystectomy（ERCP/S ＋LC）and laparoscopic common bile duct exploration（LCBDE）in the treatment of cholecystolithiasis patients with concurrent choledocholith.Methods Retrospective analysis was made of information of 280 cholecystolithiasis patients with concurrent choledocholith,who were randomly divided into group A （n =60）and group B （n =220）.group A was arranged with LCBDE and group B was treated ERCP/S ＋LC. The operation time,hospital stay after operation,hospitalization fee,size of common bile duct calculi,stone clearance rate and the incidence of postoperative complications were compared.Results The operation time,hospital stay after operation,hospitalization fee,size of the common bile duct calculi,stone clearance rate and the incidence of postopera-tive complications of group A ＆amp;B were （95.58 ±22.66）m vs.（87.46 ±40.25）m,（15.18 ±5.46）d vs.（14.32 ± 4.21）d,（2.45 ±0.32）ten thousand yuan vs.（2.89 ±0.64）ten thousand yuan,（1.12 ±0.34）cm vs.（1.39 ± 0.38）cm,96.6% vs.91% and 1.6% vs.3.2%.There was no significant difference in calculus clearance rate between the two treatments（χ2 =1.44,P 〉0.05 ）.Patients in LCBDE group spent slightly less on hospitalization expenses than patients in ERCP/S ＋LC group,but there was no significant difference shown（t =0.923,P 〉0.05）. Patients in ERCP/S ＋LC group had suffered a relatively high incidence of complications than patients in LCBDE group,and significant difference was found（χ^2 =4.17,P 〈0.05）.Conclusion Both LCBDE and ERCP/S ＋LC are effective minimally invasive therapies for concurrent cholecystolithiasis and choledocholith,and should be clinically applied in accordance with their specific characteristics.
出处
《中国基层医药》
CAS
2015年第18期2721-2723,共3页
Chinese Journal of Primary Medicine and Pharmacy
基金
基金项目：湖北省天门市科研项目（K-118002）
关键词
胆囊结石病
胆总管结石
胆囊切除术
腹腔镜
Cholecystolithiasis
Choledocholithiasis
Cholecystectomy,Laparoscopic
