肝胆胰外科杂志2026，Vol.38Issue(1)：22-26,5.DOI:10.11952/j.issn.1007-1954.2026.01.005
单孔加一孔LCBDE一期缝合联合LC治疗胆囊结石合并胆总管结石的效果分析
Efficacy of single-incision plus one-port LCBDE with primary suture combined with LC for cholecystolithiasis complicated by choledocholithiasis
摘要
Abstract
Objective To analyze the efficacy of single-incision plus one-port laparoscopic common bile duct exploration(LCBDE)with primary suture combined with laparoscopic cholecystectomy(LC)versus endoscopic retrograde cholangiopancreatography(ERCP)followed by three-port LC in the treatment of cholecystolithiasis complicated by choledocholithiasis.Methods Clinical data of 81 patients with cholecystolithiasis complicated by choledocholithiasis treated in the First Affiliated Hospital of Ningbo University from August 2022 to December 2024 were retrospectively analyzed.Patients were divided into two groups:the observation group(n=46)underwent single-incision plus one-port LCBDE with primary suture combined with LC,and the control group(n=35)underwent ERCP followed by three-port LC.Operation time,intraoperative blood loss,pre-and postoperative levels of white blood cell(WBC)count,C-reactive protein(CRP),total bilirubin(TBIL),alanine aminotransferase(ALT),and aspartate aminotransferase(AST),incidence of postoperative bile leak and post-ERCP pancreatitis(PEP),Numerical Rating Scale(NRS)score,drainage duration,total hospitalization cost,and time of hospital stay were compared.Results Compared with the control group,the observation group had a longer operation time[140.00(124.80,156.30)min vs 98.50(77.00,114.50)min,Z=5.290,P<0.001]and greater intraoperative blood loss[10.00(5.00,12.50)mL vs 7.00(5.00,7.00)mL,Z=3.335,P=0.001].No significant differences were found in postoperative inflammatory and liver function markers(all P>0.05).The observation group and the control group showed a statistically significant difference in the incidence of postoperative bile leakage[6(13.04%)vs 0,P=0.026]and PEP[0 vs 3(8.57%),P=0.043].The observation group demonstrated lower postoperative NRS scores,lower total hospitalization costs,and a shorter time of hospital stay(all P<0.05).Conclusion For cholecystolithiasis complicated by choledocholithiasis,single-incision plus one-port LCBDE with primary suture combined with LC demonstrates comparable efficacy and safety to ERCP followed by three-port LC,while offering advantages in postoperative pain control,hospitalization costs,and time of hospital stay.关键词
单孔加一孔/腹腔镜胆总管探查/腹腔镜胆囊切除术/内镜逆行胰胆管造影/胆囊结石/胆总管结石/一期缝合Key words
single-incision plus one port/laparoscopic common bile duct exploration/laparoscopic cholecystectomy/endoscopic retrograde cholangiopancreatography/cholecystolithiasis/choledocholithiasis/primary closure分类
医药卫生引用本文复制引用
曹智凯,胡涛,李宇轩,杨晓平..单孔加一孔LCBDE一期缝合联合LC治疗胆囊结石合并胆总管结石的效果分析[J].肝胆胰外科杂志,2026,38(1):22-26,5.基金项目
宁波市自然科学基金(2023J154). （2023J154）
