摘要
目的探讨内窥镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatographyERCP)+内窥镜下括约肌切开术(endoscopic sphincterotomy EST)术后不同手术时机行腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)的治疗结果。方法回顾性分析2015年2月至2018年2月新疆医科大学第一附属医院行微创手术治疗的胆总管结石合并胆囊结石的120例患者,其中62例患者于ERCP + EST术后48 ~ 72 h行LC(观察组),58例于ERCP + EST术后72 h后行LC(对照组),比较两组患者平均住院天数、平均住院费用、中转开腹率、术中出血量、手术时间、术后并发症。结果所有患者围手术期均未发生死亡,术后达到临床治愈标准后出院。两组患者的年龄、性别.ERCP手术时间、胆总管结石直径、数目及术后并发症的比较,差异无统计学意义(P〉0. 05)。观察组患者LC手术时间、术中出血量、住院时间、中转开腹率、住院费用都显著低于对照组,差异有统计学意义(P<0.05)。结论ERCP + EST术后48-72 h内行LC具有中转开腹率低、手术时间短、住院费用低等优点。
Objective To evaluate the timing of postoperative laparoscopic cholecystectomy ( LC) after ERCP for the treatment of gallstones. Method A retrospective analysis was made on 120 patients with choledocholithiasis and cholecystolithiasis from Feb 2015 to Feb 2018 in the First Affiliated Hospital of Xinjiang Medical University, including 62 patients receiving LC at 48 -72 h after ERCP + EST (observation group), and 58 patients receiving LC at 72h after ERCP + EST ( control group). The hospital stay , hospitalization costs , operation time, intraoperative blood loss , convertion to open laparotomy , the postoperative complications were compared between the two groups. Results The difference of age, gender, ERCP operation time, common bile duct stones diameter, postoperative complications were not statistically significant in two groups. Operation time , intraoperative blood loss , hospital stay, incidence of laparotomy and hospitalization costs in group A were significantly less than that in group B ( P < 0. 05 ). Conclusions ERCP + EST followed by LC for choledocholithiasis with cholecystolithiasis within 48 - 72 hours were with shorter operation time, lower hospital costs, without an increase of postoperative complications compared with ERCP + EST followed by LC after 72 hours.
作者
郭强
蒋铁民
冉博
阿依甫汗·阿汗
邵英梅
吐尔干艾力·阿吉
Guo Qiang;Jiang Tiemin;Ran Bo;Ayifuhan·Ahan;Shao Yingmei;Tuerganaili·Aji(Department of Liver and Laparoscopic Surgery, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China)
出处
《中华普通外科杂志》
CSCD
北大核心
2019年第7期568-571,共4页
Chinese Journal of General Surgery
基金
国家自然科学基金(81660108)
自治区“十三五”重点学科(高峰学科)[新教研(2016)7号].
关键词
胆总管结石
胰胆管造影
内窥镜逆行
括约肌切开术
内窥镜
Choledocholithiasis
Cholangiopancreatography, endoscopic retrograde
Sphincterotomy, endoscopic
