CAJ | 학술논문

目的：探讨腹腔镜胆囊切除术( LC)联合内镜乳头括约肌切开术( EST)治疗胆囊结石合并胆总管结石的临床效果。方法回顾性分析LC联合EST治疗胆囊结石合并胆总管结石652例病例情况。结果652例中EST成功634例(97.2%)，再行LC成功621例(97.9%)。 LC后平均住院4 d(2~15 d)。652例中有 EST前伴有急性胰腺炎171例；不伴有急性胰腺炎481例，但EST后并发胰腺炎62例(13.1%)。621例LC后，合并胆汁漏8例(1.2%)，经术中引流而愈；合并胆囊区积液120例(19.0%)，其中118例自愈，另外2例脓肿形成在超声引导下经皮穿刺置管引流而愈。结论 LC联合EST治疗胆囊结石合并胆总管结石有治愈率高、住院时间短、并发症轻等优点，安全有效。
목적：탐토복강경담낭절제술( LC)연합내경유두괄약기절개술( EST)치료담낭결석합병담총관결석적림상효과。방법회고성분석LC연합EST치료담낭결석합병담총관결석652례병례정황。결과652례중EST성공634례(97.2%)，재행LC성공621례(97.9%)。 LC후평균주원4 d(2~15 d)。652례중유 EST전반유급성이선염171례；불반유급성이선염481례，단EST후병발이선염62례(13.1%)。621례LC후，합병담즙루8례(1.2%)，경술중인류이유；합병담낭구적액120례(19.0%)，기중118례자유，령외2례농종형성재초성인도하경피천자치관인류이유。결론 LC연합EST치료담낭결석합병담총관결석유치유솔고、주원시간단、병발증경등우점，안전유효。
Objective To evaluate the clinical effectiveness of laparoscopic cholecystectomy ( LC) combined with endoscopic sphincter-otomy ( EST) for treatment of gallstones with common bile duct stones. Methods Clinical data of 652 patients who were treated by LCs and ESTs were retrospectively analyzed. Results ESTs were successfully accomplished in 634 patients (97. 2%), and LCs were successfully ac-complished in 621 among the 634 patients (97. 9%) after ESTs. The mean length of hospitalization after LCs was 4 days (2~15 days). In all 652 patients, there were 233 cases of acute pancreatitis, including 171 cases before ESTs and 62 cases (13. 1%) after ESTs, and they were all cured after ESTs. In 621 patients after LCs, bile leakages occurred in 8 patients (1. 2%) and they were cured with intraoperative drainages. Local fluid accumulations occurred in 120 patients (19. 0%), and 118 cases of them healed without management, and the other 2 cases were cured with percutaneous tube-placement drainages guided by ultrasonography because of abscesses. Conclusion It is safe and effective to treat gallstones with common bile duct stones by LC combined with EST because of its high success rate, short hospital stay and mild complications.