CAJ | 학술논문

目的探讨腹腔镜胆总管切开取石术(laparoscopic common bile duct exploration,LCBDE)治疗胆总管结石的优越性.方法回顾分析2001年6月至2006年6月间,在贵港市人民医院及广西壮族自治区人民医院微创中心行微创手术治疗的胆总管结石的临床资料.按手术方式不同分两组,即LCBDE组和EST(内镜乳头括约肌切开取石术,endoscopic sphincterotomy)组,比较两组的远期疗效.结果该组225例,其中LCBDE 106例,EST 119例.术后随访1～6年,平均(3.2±0.8)年.LCBDE组结石复发率为3.77%(4/106),反流性胆管炎的发生率为2.83%(3/106),无乳头狭窄;EST组结石复发率为11.76%(14/119),乳头狭窄的发生率为7.56%(9/119),反流性胆管炎的发生率为12.61%(15/119).全组病例无胆管癌发生.术后结石复发率、乳头狭窄和反流性胆管炎的发生率在两组间的差别均有统计学意义.结论在治疗胆总管结石方面,LCBDE的远期疗效优于EST.
목적 탐토복강경담총관절개취석술(laparoscopic common bile duct exploration,LCBDE)치료담총관결석적우월성.방법 회고분석2001년6월지2006년6월간,재귀항시인민의원급엄서장족자치구인민의원미창중심행미창수술치료적담총관결석적림상자료.안수술방식불동분량조,즉LCBDE조화EST(내경유두괄약기절개취석술,endoscopic sphincterotomy)조,비교량조적원기료효.결과 해조225례,기중LCBDE 106례,EST 119례.술후수방1～6년,평균(3.2±0.8)년.LCBDE조결석복발솔위3.77%(4/106),반류성담관염적발생솔위2.83%(3/106),무유두협착;EST조결석복발솔위11.76%(14/119),유두협착적발생솔위7.56%(9/119),반류성담관염적발생솔위12.61%(15/119).전조병례무담관암발생.술후결석복발솔、유두협착화반류성담관염적발생솔재량조간적차별균유통계학의의.결론 재치료담총관결석방면,LCBDE적원기료효우우EST.
Objective To investigate the advantage of laparoscopic common bile duct exploration for common bile duct stone. Methods The clinical data of the patients with common bile duct stone receiving minimally invasive surgery in Guigang People's Hospital and Guangxi People's Hospital from June 2001 to June 2006 were retrospectively analyzed. The long-term therapeutic efficacy was compared between the patients undergoing laparoscopie common bile duct exploration(LCBDE group)and those receiving endoscopic sphincterotomy(EST). Results A total of 225 cases were included in this study. Of the patients, 106 received LCBDE and 119 EST. All the patients were followed up for an average of 3.2±0.8 years(1-6 years). In LCBDE group, bile duct recurrent stones was seen in 4 cases(3.77%) and cholangitis in 3(2.83%) and no duodenal papilla stenosis. In EST group, bile duct recurrent stones was seen in 14 cases(11.76%), duodenal papilla stenosis in 9(7.56%) and cholangitis in 15 cases(12.60%). No cholangiocarcinoma was experienced in all the patients. Long-term complications such as bile duct recurrent stones, duodenal papilla stenosis and cholangitis had significant differences between the 2 groups(P<0.05). Conclusion LCBDE is better than EST for common bile duct stone with the advantage of less long-term complications.