摘要
目的比较腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)后同期行内镜下逆行胰胆管造影(endoscopic retrograde cholangiopancreatography, ERCP)与ERCP术后二期行LC治疗胆囊结石合并胆总管结石的疗效,探讨同期LC+ERCP治疗胆囊结石合并胆总管结石的临床价值。方法 62例胆囊结石合并胆总管结石患者,根据手术方式分为观察组28例和对照组34例,观察组行同期LC+ERCP治疗,对照组于ERCP术后二期行LC治疗,比较2组患者临床资料及术后住院时间、并发症发生率、术前及术后1个月血清前白蛋白和白蛋白水平。术后第3天行经鼻胆管造影,观察2组结石清除情况。结果 2组体质量指数、胆总管结石数量和直径、胆总管直径及谷丙转氨酶、总胆红素水平比较差异无统计学意义(P>0.05)。观察组术后住院时间[(7.0±1.5)d]短于对照组[(8.8±1.5)d](P<0.05),术后并发症发生率(7.1%)与对照组(8.8%)比较差异无统计学意义(P>0.05)。观察组术前及术后1个月血清前白蛋白[(238.2±19.5)、(285.7±21.5)g/L]和白蛋白[(31.7±3.4)、(37.5±3.0)g/L]水平与对照组[(243.1±20.8)、(285.1±22.8)g/L,(32.5±3.4)、(37.2±2.7)g/L]比较差异均无统计学意义(P>0.05);2组术后1个月血清前白蛋白及白蛋白水平均高于术前(P<0.05)。2组术后第3天经鼻胆管造影显示结石清除率均为100%。结论同期LC+ERCP治疗胆囊结石合并胆总管结石安全、有效,住院时间短。
Objective To compare the efficacies of laparoscopic cholecystectomy(LC) + endoscopic restrograde cholangiopancreatography(ERCP) versus LC after ERCP in the treatment of cholecystolithiasis and choledochlithiasis, and to investigate the clinical value of LC+ERCP. Methods Sixty-two patients with cholecystolithiasis and choledochlithiasis were divided into 28 patients undergoing LC+ERCP(observation group) and 34 patients undergoing LC after ERCP(control group). The clinical data, postoperative hospital stay, incidence of complications, and prealbumin and albumin levels before and 1 month after surgery were compared between two groups. Transnasal cholangiography was performed on the third day after operation to observe the calculi clearance. Results There were no significant differences in body mass index, number and diameter of choledocholithiasis, diameter of common bile duct glutamic-pyruvic transaminase and total bilirubin between two groups(P>0.05). The length of postoperative hospital stay was shorter in observation group((7.0±1.5) d) than that in control group((8.8±1.5) d)(P<0.05), and the total incidence of postoperative complications showed no significant difference between observation group(7.1%) and control group(8.8%)(P>0.05). There were no significant differences in the levels of prealbumin and albumin before and one month after operation between observation group(prealbumin:(238.2±19.5),(285.7±21.5) g/L;albumin:(31.7±3.4),(37.5±3.0) g/L) and control group(prealbumin:(243.1±20.8),(285.1±22.8) g/L;albumin:(32.5±3.4),(37.2±2.7) g/L)(P>0.05). The levels of prealbumin and albumin one month after operation were higher than those before operation in two groups(P<0.05). The clearance rate of calculi on the third day after operation was 100% in both groups. Conclusion LC+ERCP is safe and effective for cholecystolithiasis and choledochlithiasis, and the hospital stay is short.
作者
侯潇峰
宋展
刘驰
戴兵
HOU Xiao-feng;SONG Zhan;LIU Chi;DAI Bing(Grade 2018,Xinxiang Medical University,Xinxiang,Henan 453000,China;Department of General Surgery,Nanyang Center Hospital,Nanyang,Henan 473000,China)
出处
《中华实用诊断与治疗杂志》
2021年第2期156-158,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
胆囊结石
胆总管结石
内镜下逆行胰胆管造影术
胆囊切除
腹腔镜
cholecystolithiasis
choledocholithiasis
endoscopic retrograde cholangiopancreatography
cholecystectomy
laparoscopy
