摘要
Abstract
Objective:To compare the therapeutic effects and safety of endoscopic retrograde cholangiopancreatography ( ER-CP)/endoscopic sphincterotomy ( EST) plus laparoscopic cholecystectomy ( LC) and LC plus laparoscopic common bile duct explora-tion ( LCBDE) for cholecystolithiasis combined with choledocholithiasis .Methods:The clinical data of cholecystolithiasis with choledo-cholithiasis patients from Jan.2013 to Aug.2014 were analyzed retrospectively.During this period,87 patients were treated by ERCP/EST+LC and 71 patients by LC +LCBDE.Results:There were no statistically significant differences in the age ,gender,number of stones,stone diameter and common bile duct diameter in two groups (P>0.05).No significant differences were observed in terms of operation success rate (94.25%vs.92.96%,P=0.452),conversion to open surgery rate (5.75%vs.7.04%,P=0.452) and inci-dence of postoperative complication (3.45%vs.2.82%,P=0.168) in two groups.However,operation time [(105.7 ±9.2) min vs. (132.4 ±15.1) min,P=0.012] and hospital stay [(5.5 ±2.8) d vs.(6.9 ±3.4) d,P=0.008] were shorter in LC +LCBDE group than those in ERCP/EST+LC group,and hospitalization charges in LC +LCBDE group were less than that in ERCP/EST+LC group [(5 347.1 ±672.1) yuan vs.(7 923.5 ±657.2) yuan,P=0.002].The results of short-term follow-up suggested that the clear-ance rate of calculus in two groups showed no significant difference (97.7%vs.100%,P=0.219).Conclusions:In the treatment of patients suffered from cholecystolithiasis with choledocholithiasis ,both LC+LCBDE and ERCP/EST+LC are safe and effective .LC+LCBDE is associated with better cost performance ,less operation time and hospital stay .Thus,LC+LCBDE is a preferred choice for the appropriate cases of cholecystolithiasis combined with choledocholithiasis .关键词
胆囊结石病/胆总管结石/胆囊切除术,腹腔镜/胆总管探查取石术/胰胆管造影术,内窥镜逆行/括约肌切开术,内窥镜Key words
Cholecystolithiasis/Choledocholithiasis/Cholecystectomy,laparoscopic/Common bile duct exploration/Cholangio-pancreatography ,endoscopic retrograde/Sphincterotomy ,endoscopic分类
医药卫生
