腹腔镜外科杂志2025，Vol.30Issue(11)：814-820,7.DOI:10.13499/j.cnki.fqjwkzz.2025.11.814
胆囊结石合并胆总管结石三种治疗方法的疗效分析
Efficacy analysis of three treatment methods for cholecystolithiasis with choledocholithiasis
摘要
Abstract
Objective:To compare and analyze the clinical efficacy of three treatment methods for cholecystolithiasis with chole-docholithiasis.Methods:The clinical data of 96 patients with cholecystolithiasis and choledocholithiasis admitted from Apr.2021 to Oct.2024 were retrospectively analyzed.According to the treatment methods,patients were divided into Group A(undergoing laparo-scopic cholecystectomy combined with transcystic duct ultra-fine choledochoscopic exploration and stone removal,n=35),Group B(un-dergoing laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration,n=38),and Group C(undergoing laparoscopic cholecystectomy combined with endoscopic retrograde cholangio pancreatography/endoscopic sphincterotomy,n=23).The clinical parameters of the three groups were compared.Results:There were no statistically significant differences in baseline clinical da-ta among the three groups.Postoperative levels of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,gamma-glutamyl transpeptidase,total bilirubin,direct bilirubin,white blood cell count,and neutrophil count were lower in Group A(P<0.05).Lymphocyte count was within the normal range only in Group A(P<0.05).Postoperative creatinine,glucose,cholesterol,and Ca2+lev-els were within the normal range in the 3 groups(P<0.05).Compared with Groups B and C,Group A had less intraoperative blood loss,shorter gastrointestinal function recovery time and postoperative hospital stay,and lower total hospitalization cost.The operative time in Group A was shorter than that in Group B,but longer than that in Group C(P<0.05).Postoperative serum amylase elevation oc-curred in 1 case in Group B and 3 cases in Group C,but no case was observed in Group A(P<0.05).There were2 cases of bile leak-age in Group B,while no bile leakage occurred in Groups A and C(P>0.05).No statistically significant difference was found in the in-cidence of residual stone among the three groups(P>0.05).Conclusions:Under the premise of strict patient selection,laparoscopic cholecystectomy combined with transcystic duct ultra-fine choledochoscopic exploration and stone removal has the advantages of minimal invasion,rapid recovery,short operation time,and low cost.The specific surgical procedure should be chosen based on clinical circum-stances.关键词
胆总管结石病/胆囊结石病/胆囊切除术,腹腔镜/胆道镜检查/经胆囊管/十二指肠镜检查Key words
Choledocholithiasis/Cholecystolithiasis/Cholecystectomy,laparoscopic/Choledochoscopy/Transcystic/Duodenos-copy分类
医药卫生引用本文复制引用
陈骑东,王勇,王志成,秦锡亮,韩红彪,朱超,周帅,刘会春,金浩..胆囊结石合并胆总管结石三种治疗方法的疗效分析[J].腹腔镜外科杂志,2025,30(11):814-820,7.基金项目
安徽省教育厅高校自然科学研究重点项目(2022AH052337) （2022AH052337）
安徽省高校自然科学研究重大项目(2023AH040392) （2023AH040392）
安徽省高校自然科学研究重点项目(2023AH053366) （2023AH053366）
安徽省高校自然科学研究重点项目(2023AH053384) （2023AH053384）
蚌埠医科大学研究生科研创新项目(Byycx25033) （Byycx25033）
蚌埠医科大学研究生科研创新项目(Byycx23120) （Byycx23120）
蚌埠医科大学研究生科研创新项目(Byycx23124) （Byycx23124）
