CAJ | 학술논문

目的：探讨腹腔镜胆囊切除术（LC）联合经十二指肠镜逆行胆胰管造影（ERCP）同期治疗胆囊结石并肝外型肝胆管结石的临床疗效及意义。方法回顾性分析LC联合ERCP同期治疗胆囊结石并肝外型肝胆管结石30例患者（A组）和LC联合腹腔镜胆总管探查（1aparoscopic common bile duct exploration，LCBDE）32例患者（B组）的临床资料，对两组患者的手术时间、术中出血量、中转开腹数、术后下床活动时间、结石残留率、术后并发症、住院总费用和平均总住院日等指标进行对比分析。结果研究结果提示两种术式的住院总费用及平均总住院日差异有统计学意义（P<0.05），而手术时间、术中出血量、中转开腹、术后下床活动时间、结石残留率及手术并发症差异无统计学意义（P>0.05）。结论腹腔镜联合十二指肠镜同期治疗胆囊结石并肝外型肝胆管结石具有恢复快、住院时间短等优点，可能是一种安全、可行的微创手术方式。
목적：탐토복강경담낭절제술（LC）연합경십이지장경역행담이관조영（ERCP）동기치료담낭결석병간외형간담관결석적림상료효급의의。방법회고성분석LC연합ERCP동기치료담낭결석병간외형간담관결석30례환자（A조）화LC연합복강경담총관탐사（1aparoscopic common bile duct exploration，LCBDE）32례환자（B조）적림상자료，대량조환자적수술시간、술중출혈량、중전개복수、술후하상활동시간、결석잔류솔、술후병발증、주원총비용화평균총주원일등지표진행대비분석。결과연구결과제시량충술식적주원총비용급평균총주원일차이유통계학의의（P<0.05），이수술시간、술중출혈량、중전개복、술후하상활동시간、결석잔류솔급수술병발증차이무통계학의의（P>0.05）。결론복강경연합십이지장경동기치료담낭결석병간외형간담관결석구유회복쾌、주원시간단등우점，가능시일충안전、가행적미창수술방식。
Objective To assess the clinical effects of combined endoscopic-laparoscopic technique for one-stage treatment of cholelithiasis with concomitant choledocholithiasis. Methods A retrospective analysis was conducted of the clinical data of 30 patients (Group A) with cholelithiasis and choledocholithiasis receiving one- stage laparoscopic cholecystectomy (LC) combined with intraoperative encoscopic retrograde cholangio-pancreatography (ERCP) and 32 patients (Group B) receiving LC combined with 1aparoscopic common bile duct exploration. The operative time, blood loss, conversion to open surgery rate, time to postoperative ambulation, calculi residual rate, hospitalization cost and length of hospital stay were analyzed comparatively. Results There were statistically differences between the two groups in hospitalization cost and length of hospital stay (P<0.05) but not in the other indices (P>0.05). Conclusion Combined endoscopic-laparoscopic techniques can be a safe and feasible option for one- stage treatment of concomitant cholelithiasis and choledocholithiasis to allow rapid postoperative recovery with a shortened hospital stay.