肝胆胰外科杂志2024，Vol.36Issue(3)：155-160,6.DOI:10.11952/j.issn.1007-1954.2024.03.005
LC+LERV与LC+LCBDE治疗胆囊结石合并胆总管结石的临床效果比较
Clinical efficacy between LC+LERV and LC+LCBDE in the treatment of gallbladder stones combined with common bile duct stones
摘要
Abstract
Objective To compare the clinical efficacy of laparoscopic cholecystectomy(LC)combined with laparo-endoscopic rendezvous(LERV)and LC+laparoscopic common bile duct exploration(LCBDE)in the treatment of gallbladder stones combined with common bile duct stones.Methods A prospective study was conducted in 110 patients with gallbladder stones and common bile duct stones who admitted to Jiangyou People's Hospital and Weifang People's Hospital between Dec.2021 and May 2023.With a random number table method,patients were randomly divided into LC+LERV group(n=54)and LC+LCBDE group(n=56).The surgical success rate,intraoperative bleeding volume,operation time,time of indwelling drainage tube,postoperative complications,hospitalization time and hospitalization costs,pain visual analogue scale(VAS)of the two groups were compared.Results Compared with the LC+LCBDE group,the LC+LERV group had lower surgical success rate(87.04%vs 100.00%,χ2=7.467,P=0.006),longer operation time[(112.0±15.6)min vs(98.0±21.5)min,t=3.771,P<0.001],and shorter time of indwelling drainage tube[(2.34±0.66)d vs(7.41±12.88)d,t=-2.693,P=0.008],the differences were all statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of intraoperative bleeding volume and incidence of postoperative complications(P>0.05).There was no statistically significant difference in VAS scores between the two groups before surgery,6 h and 1 d after surgery,on the day of discharge(P>0.05),but the VAS score 3 d after surgery in the LC+LCBDE group was significantly higher than that in the LC+LERV group(P<0.05).There was no statistically significant difference in hospitalization time between the two groups(P>0.05),but the hospitalization cost in the LC+LERV group was significantly higher than that in the LC+LCBDE group[(25653.6±3317.0)yuan vs(17 978.4±2158.0)yuan,t=14.219,P<0.001].Conclusion For treatment of gallbladder stones combined with common bile duct stones,LC+LCBDE and LC+LERV have the same safety performance,and LC+LERV has better postoperative comfort.LC+LCBDE is more effective and cost-effective,and LC+LCBDE can be used as a remedial surgery for LC+LERV intubation or stone removal failure.关键词
腹腔镜胆囊切除术(LC)/腹腔镜术中联合内镜(LERV)/腹腔镜胆总管切开取石术(LCBDE)/胆囊结石/胆总管结石Key words
laparoscopic cholecystectomy/laparo-endoscopic rendezvous/laparoscopic common bile duct exploration/gallbladder stones/common bile duct stones分类
医药卫生引用本文复制引用
陈庆,王春斐,何彦安,严超,何永红..LC+LERV与LC+LCBDE治疗胆囊结石合并胆总管结石的临床效果比较[J].肝胆胰外科杂志,2024,36(3):155-160,6.基金项目
江油市重点科技计划项目(2021-32). （2021-32）
