CAJ | 학술논문

目的：探讨经十二指肠乳头括约肌切开取石(endoscopic sphincterotomy,EST)术后再行腹腔镜胆囊切除手术( la-paroscopic cholecystectomy,LC）可遵循的临床依据和策略。方法选择30例明确诊断胆囊结石并胆总管结石患者，随机分为2组，每组15例，研究组按照以EST 后可能出现影响LC 进行的并发症为参考依据来选择LC 的手术时机，对照组按照通常EST 后临床症状完全消失、各项检查结果恢复正常时行LC。比较两组EST 后行LC 的手术时间选择、主要并发症情况。结果两组在LC术后并发症、恢复时间上无显著差异，研究组在EST后再行LC手术的间隔时间明显缩短（P<0.05），总的住院日和医疗费用有明显减少。结论按照以EST 后可能出现影响LC 进行的并发症为参考依据来选择LC 的最佳手术时机是切实可行的一条路径。
목적：탐토경십이지장유두괄약기절개취석(endoscopic sphincterotomy,EST)술후재행복강경담낭절제수술( la-paroscopic cholecystectomy,LC）가준순적림상의거화책략。방법선택30례명학진단담낭결석병담총관결석환자，수궤분위2조，매조15례，연구조안조이EST 후가능출현영향LC 진행적병발증위삼고의거래선택LC 적수술시궤，대조조안조통상EST 후림상증상완전소실、각항검사결과회복정상시행LC。비교량조EST 후행LC 적수술시간선택、주요병발증정황。결과량조재LC술후병발증、회복시간상무현저차이，연구조재EST후재행LC수술적간격시간명현축단（P<0.05），총적주원일화의료비용유명현감소。결론안조이EST 후가능출현영향LC 진행적병발증위삼고의거래선택LC 적최가수술시궤시절실가행적일조로경。
Objective To discuss the clinical basis and strategy of LC timing choice after EST. Methods 30 patients of cholecystolithiasis and choledocholithiasis were divided into two groups randomly with 15 cases each. In the experimental group , LC operations were performed based on whether the complications of EST may affect LC or not,while in the control group,LC op-erations were performed only after the complete disappearance of clinical symptoms and all the examination results went back to normal. The operation time and complications of LC were compared between these two groups. Results There was no significant difference of complications incidence and recovery time between groups,whereas the interval time of LC was significantly short-ened in the experimental group,so that the length of stay and the medical cost were definitely reduced. Conclusion The optimal timing of LC could be based on whether the complications of EST may affect LC or not.