肝胆胰外科杂志2025，Vol.37Issue(6)：372-375,4.DOI:10.11952/j.issn.1007-1954.2025.06.003
胆道子镜直视下激光碎石治疗高龄巨大胆总管结石的效果分析
Clinical effect of laser lithotripsy under the direct view of biliary subendoscope in the treatment of elderly patients with giant common bile duct stones
摘要
Abstract
Objective To evaluate the effectiveness of laser lithotripsy under the direct view of biliary subendoscope in the treatment of elderly patients with giant common bile duct stones.Methods A retrospective analysis was conducted on 60 elderly patients(≥80 years)with giant common bile duct stones(diameter≥1.5 cm),who received ERCP treatment in Shanghai Putuo Hospital from Jan.2019 to Dec.2023.Patients were divided into two groups:the mechanical lithotripsy group(n=30)and the biliary subendoscope group(n=30).The success rates of stone removal and complication incidence rates were compared between the two groups.Results(1)Compared with the mechanical lithotripsy group,the biliary subendoscope group had a higher success rate of complete stone removal[83.3%(25/30)vs 50.0%(15/30),P<0.05]).(2)In all successful removal cases,there were no statistically significant difference between the mechanical lithotripsy group and the biliary subendoscope group[(62.9±14.9)min vs(70.0±11.8)min,P>0.05].(3)The complication incidence rates between the mechanical lithotripsy group and the biliary subendoscope group showed no statistically significant difference[23.3%(7/30)vs 16.7%(5/30),P>0.05].(4)Compared with the mechanical lithotripsy group,the biliary subendoscope group had a shorter hospitalization time[(9.2±3.5)d vs(14.1±3.2)d],and higher hospitalization costs[(7.2±1.3)ten thousand yuan vs(5.5±1.5)ten thousand yuan],both with statistically significant difference(P<0.05).Conclusion Laser lithotripsy under the direct view of biliary subendoscope in the treatment of elderly patients with giant common bile duct stones is safer.It can reduce the operation time and the hospitalization time.关键词
胆道子镜/激光碎石/高龄患者/巨大胆总管结石/临床疗效Key words
biliary subendoscope/laser lithotripsy/elderly patients/giant common bile duct stones/clinical分类
临床医学引用本文复制引用
于昆,杨佳华,司仙科,李森,李炜,张计训,曹亦军..胆道子镜直视下激光碎石治疗高龄巨大胆总管结石的效果分析[J].肝胆胰外科杂志,2025,37(6):372-375,4.基金项目
上海市卫生健康系统重点学科建设项目(2024ZDXK0046) （2024ZDXK0046）
上海市普陀区卫生健康委员会特色专病建设项目——胆石病(2024tszb01) （2024tszb01）
上海市普陀区卫生健康系统科技创新项目(ptkww202308). （ptkww202308）
