摘要
目的比较一期腹腔镜胆囊切除术(LC)联合腹腔镜胆总管探查术(LCBDE)与经内镜逆行胰胆管造影(ERCP)后择期行LC治疗胆囊结石合并胆总管结石的临床效果。方法选取我院2013年1月至2016年12月期间收治的251例胆囊结石合并胆总管结石患者,按手术方式分为LC+LCBDE组(184例)和ERCP+LC组(67例)。观察和比较两组患者的临床效果。结果两组患者的手术成功率、结石残留率和术中转开腹率比较差异均无统计学意义(P>0.05)。LC+LCBDE组的手术时间和住院时间均显著短于ERCP+LC组(P<0.05)。LC+LCBDE组的结石复发率和并发症发生率均显著低于ERCP+LC组(P<0.05)。LC+LCBDE组的术中出血量和住院费用均显著少于ERCP+LC组(P<0.05)。结论与ERCP后择期行LC比较,一期LC联合LCBDE治疗胆囊结石合并胆总管结石的安全性较高,临床效果较好。
Objective To compare the clinical effect of one-staged laparoscopic cholecystectomy （LC） combined with laparoscopic common bile duct exploration （LCBDE） and elective LC after endoscopic retrograde cholangiopancreatography （ERCP） in the treatment of cholecystolithiasis complicated with choledocholithiasis. Methods A total of 251 cases of patients with cholecystolithiasis complicated with choledocholithiasis admitted to our hospital from January 2013 and December 2016 were selected and divided into LC ＋ LCBDE group （184 cases） and ERCP ＋ LC group （67 cases） according to their surgical methods. The clinical effect of patients were observed and compared between two groups. Results No statistical difference was found in the surgical success rate, residual rate and the rate of conversion to laparotomy between two groups （P〉0.05）. The surgical time and hospitalization time ofLC ＋ LCBDE group were significantly shorter than those of ERCP ＋ LC group （P〈0.05）. The recurrence rate and incidence of complications ofLC ＋ LCBDE group were significantly lower than those of ERCP ＋ LC group （P〈0.05）. The intraoperative blood loss and hospitalization expenses were significantly less than those of ERCP ＋ LC group （P〈0.05）. Conclusions Compared with elective LC after ERCP, one-staged LC combined with LCBDE has higher safety and better clinical effect in the treatment of cholecystolithiasis complicated with choledocholithiasis.
出处
《临床医学工程》
2017年第7期897-898,共2页
Clinical Medicine & Engineering
关键词
胆囊结石
胆总管结石
腹腔镜
胆囊切除术
胆总管探查术
Cholecystolithiasis
Choledocholithiasis
Laparoscope
Cholecystectomy
Common bile duct exploration
