医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2014年
9期
149-150
,共2页
胆总管结石%胆囊多发性结石%腹腔镜胆囊切除联合胆总管探查术%内镜下十二指肠乳头括约肌切开术
膽總管結石%膽囊多髮性結石%腹腔鏡膽囊切除聯閤膽總管探查術%內鏡下十二指腸乳頭括約肌切開術
담총관결석%담낭다발성결석%복강경담낭절제연합담총관탐사술%내경하십이지장유두괄약기절개술
Common bile duct stones%Gal badder stones%Laparoscopic common bile duct exploration%Endoscopic sphincterotomy
目的：探讨胆囊多发性结石并胆总管结石的微创治疗方法的选择，对比研究腹腔镜胆囊切除联合胆总管探查术（laparoscopic common bile duct exploration, LCBDE）和内镜下十二指肠乳头括约肌切开术+腹腔镜胆囊切除（endoscopic sphincterotomy+laparoscopic cholecystectomy，EST+LC）。方法回顾分析我院2011年10月~2013年10月采用手术治疗胆囊多发性结石并胆总管结石60例的临床资料，LCBDE组28例，EST+LC组32例，两组患者的年龄、性别、体重指数、丙氨酸转氨酶、总胆红素、胆总管直径和ASA评分差异无显著性。对比研究2种微创治疗方法的住院时间、住院费用和治疗效果。结果两组患者的住院时间无显著性差异[（9.1±3.6）d vs (10.0±3.5)d,t=-1.190,P=0.255]。LCBDE组住院费用低于EST+LC组。[（1.5±0.5）万元VS（2.1±0.6）万元，t＝-5.069，P＝0.000]。两组患者的并发症和中转开腹率无显著差异[14.2%（4/28）VS15.6%（5/32），χ2＝0.000，P＝1.000]。结论 LCBDE和EST+LC都是治疗胆囊多发性结石并胆总管结石有效，安全的微创治疗方法，LCBDE组患者的住院费用明显降低，两组之间的并发症无差异显著性。
目的：探討膽囊多髮性結石併膽總管結石的微創治療方法的選擇，對比研究腹腔鏡膽囊切除聯閤膽總管探查術（laparoscopic common bile duct exploration, LCBDE）和內鏡下十二指腸乳頭括約肌切開術+腹腔鏡膽囊切除（endoscopic sphincterotomy+laparoscopic cholecystectomy，EST+LC）。方法迴顧分析我院2011年10月~2013年10月採用手術治療膽囊多髮性結石併膽總管結石60例的臨床資料，LCBDE組28例，EST+LC組32例，兩組患者的年齡、性彆、體重指數、丙氨痠轉氨酶、總膽紅素、膽總管直徑和ASA評分差異無顯著性。對比研究2種微創治療方法的住院時間、住院費用和治療效果。結果兩組患者的住院時間無顯著性差異[（9.1±3.6）d vs (10.0±3.5)d,t=-1.190,P=0.255]。LCBDE組住院費用低于EST+LC組。[（1.5±0.5）萬元VS（2.1±0.6）萬元，t＝-5.069，P＝0.000]。兩組患者的併髮癥和中轉開腹率無顯著差異[14.2%（4/28）VS15.6%（5/32），χ2＝0.000，P＝1.000]。結論 LCBDE和EST+LC都是治療膽囊多髮性結石併膽總管結石有效，安全的微創治療方法，LCBDE組患者的住院費用明顯降低，兩組之間的併髮癥無差異顯著性。
목적：탐토담낭다발성결석병담총관결석적미창치료방법적선택，대비연구복강경담낭절제연합담총관탐사술（laparoscopic common bile duct exploration, LCBDE）화내경하십이지장유두괄약기절개술+복강경담낭절제（endoscopic sphincterotomy+laparoscopic cholecystectomy，EST+LC）。방법회고분석아원2011년10월~2013년10월채용수술치료담낭다발성결석병담총관결석60례적림상자료，LCBDE조28례，EST+LC조32례，량조환자적년령、성별、체중지수、병안산전안매、총담홍소、담총관직경화ASA평분차이무현저성。대비연구2충미창치료방법적주원시간、주원비용화치료효과。결과량조환자적주원시간무현저성차이[（9.1±3.6）d vs (10.0±3.5)d,t=-1.190,P=0.255]。LCBDE조주원비용저우EST+LC조。[（1.5±0.5）만원VS（2.1±0.6）만원，t＝-5.069，P＝0.000]。량조환자적병발증화중전개복솔무현저차이[14.2%（4/28）VS15.6%（5/32），χ2＝0.000，P＝1.000]。결론 LCBDE화EST+LC도시치료담낭다발성결석병담총관결석유효，안전적미창치료방법，LCBDE조환자적주원비용명현강저，량조지간적병발증무차이현저성。
Objective To study the minimal invasive therapy method for patients with gal badder stones complicated with common bile duct stones,and compare the ef icacy of laparoscopic exploration of common bile duct LCBDE and endoscopic sphincterotomy +laparoscopic cholecystectomy (EST+ LC). Methods From Octomber 2011 to Octomber 2013,60 patients with gal adder stones complicated with common bile duct stones. received minimal invasive therapy in our hospital,including LCBDE with 28 patients ,and EST+LC with 32 patients.The age,sex, body mass index (BMI), levels of ALT and total bilirabin, diameter of the common bile duct,and ASA score were not significantly dif erent. We compared the hospital stay and cost and therapeutic outcomes between the two methods. Results No significant dif erence was observed in hospital stay and rates of surgical complications and conversion to open surgery between the two methods [(9.1±3.6)d vs (10.0±3.5)d t=-1.190, p=0.255;(14.2%(4/28)vs 15.6%(5/32),X2=0.000, P=1.000].Hower, the hospital cost of the LCBDE group was significantly lower than that of the EST+LC group [(15000±5000)RMB Vs (21000± 6000)RMB t=-5.069, p=0.000]. Conclusions Both LCBDE and EST+LC are safe and ef ective methods for patients with gal bladder stones complicated with common bile duct stones. The rates of complications of the two methods are similar, but the average cost for LCBDE is significantly less than that for EST+LC .
