摘要
目的比较内镜下乳头括约肌切开术(EST)联合腹腔镜胆囊切除术(LC)和腹腔镜胆总管探查取石术(LCBDE)联合 LC 治疗胆囊结石合并胆总管结石的效果及术式选择。方法回顾性分析60例胆囊结石合并胆总管结石分别采用 EST 联合 LC(30例)和 LCBDE 联合 LC(30例)治疗的临床资料,对结石清除率、并发症、中转开腹率和住院时间等指标进行比较。结果 EST 联合 LC 组结石清除率96.7%(29/30)、并发症发生率16.7%(5/30)、中转开腹率10.0%(3/30)、住院时间中位数17 d。LCBDE 联合 LC 组结石清除率100.0%(30/30)、并发症发生率6.7%(2/30)、中转开腹率6.7%(2/30)、住院时间中位数13 d。两组病例在结石清除率(P=1.000)、并发症率(P=0.421)、中转开腹率(P=1.000)和住院时间(P=0.055)等方面无明显差异。结论 EST 联合 LC 和 LCBDE 联合 LC 都是治疗胆囊结石合并胆总管结石安全合理的方法,应根据具体情况采用个体化的治疗方法。
Objective To compare the effects of combination of endoscopic sphincterotomy （EST） and laparoscopic cholecystectomy （LC） with that of combination of laparoscopic common bile duct exploration （LCBDE） and LC for the treatment of cholecystolithiasis and choledocholithiasis. Methods From April, 2000 to July, 2006, thirty patients with cholecystolithiasis and choledocholithiasis were treated by EST combined with LC, and thirty cases were treated by LCBDE combined with LC. The duct-clearance rates, complication rate, conversion rate and hospital length of stay in the two groups were evaluated retrospectively. Results The duct-clearance rate was 96. 7% （29/30） in the EST group compared with 100% （30/30） in the LCBDE group （P = 1. 000）. The complication rate was 16. 7% （5/30）in the EST group compared with 6. 7% （2/30）in the LCBDE group （P =0. 421 ）. The conversion rate was 10. 0% （3/30） in the EST group compared with 6. 7% （2/30） in the LCBDE group （P = 1. 000）. Hospital length of stay was a median of 17 days in the EST group, and 13 days in the LCBDE group （ P = 0. 055 ）. Conclusion Both EST combined with LC and LCBDE combined with LC are feasible methods for treatment of cholecystolithiasis and choledocholithiasis. The treatment for patients with cholecystolithiasis and choledocholithiasis must be individual- ized.
出处
《中华消化内镜杂志》
2007年第5期342-345,共4页
Chinese Journal of Digestive Endoscopy
