昆明医科大学学报2013，Vol.34Issue(6)：33-40,8.
继发性胆总管结石的治疗
Treatment of Secondary Choledocholithiasis
摘要
Abstract
Objectives To evaluate the clinical outcome of the different approach of treatment for the secondary choledocholithiasis.Methods The clinical data of 102 cases which had secondary choledocholithiasis was retrospectively analyzed from January 2010 to December 2011. The micro-invasive group had 44 cases including 25 cases of LCBDE and 19 cases of EST+ LC. The open choledocholithotomy with T- tube drainage (OCHTD) had 58 cases.Results The micro-invasive was performed successfully on 44 cases. The number of stones in the common bile duct stones of the LCBDE group(2.42) was more than that of EST + LC (1.22) (P = 0.031) . The complication occurrence of micro-invasive operation group (20.5%) was significantly lower than that of OCHTD group (55.2%) (P < 0.001).The occurrence of postoperative pain in micro-invasive operation group(18.2%)was significantly lower than that in OCHTD group(68.9%) (P < 0.001) . There was no statistical difference (P=0.057) in operative time micro-invasive operation group and OCHTD group (88.07 + 24.76 min Vs 101.17 + 43.33 min ) . The gastrointestinal tract function recovered significantly faster in LCBDE group(27.50 h) than OCHTD group(51.10 h) (P < 0.001) . The time of abdominal drainage after operation of LCBDE group(4.25 d)was significantly shorter than that of T-tube drainage of OCHTD group (7.41 d) (P < 0.001) . The median postoperative hospitalization stays of micro-invasive operation group (8 d) was significantly shorter than that of OCHTD group(13.74 d) , P < 0.001.Conclusion Both LCBDE and EST + LC were safe and reliable procedures. These procedures have low rate of complications, imply a shorter postoperative stay, and offer the patients more comfortable postoperative period than OCHTD. They are ideal procedure for treating patients with Secondary Choledocholithiasis.关键词
胆总管结石/腹腔镜胆囊切除术/胆总管切开取石术/内镜下十二指肠乳头切开取石术Key words
Choledocholithiasis/ Laparoscopic cholecystectomy/ Choledocholithotomy/ Endoscopic sphincterotomy分类
医药卫生引用本文复制引用
Shambhu Kumar Pay,邹浩,王琳,张小文..继发性胆总管结石的治疗[J].昆明医科大学学报,2013,34(6):33-40,8.基金项目
国家自然科学基金项目(81260084) （81260084）
云南省科技厅- 昆明医科大学联合专项重点项目(2011FB162) （2011FB162）
