岭南现代临床外科
嶺南現代臨床外科
령남현대림상외과
LINGNAN MODERN CLINICS IN SURGERY
2014年
3期
267-270
,共4页
刘清波%王卫东%陈小伍%吴志强%何威%陈坚平%林杰
劉清波%王衛東%陳小伍%吳誌彊%何威%陳堅平%林傑
류청파%왕위동%진소오%오지강%하위%진견평%림걸
胆总管结石合并胆囊结石%LCBDE+LC%ERCP+LC
膽總管結石閤併膽囊結石%LCBDE+LC%ERCP+LC
담총관결석합병담낭결석%LCBDE+LC%ERCP+LC
Cholecysto-Choledocholithiasis%LCBDE+LC%ERCP+LC
目的:探讨胆总管结石合并胆囊结石的两种不同处理方法的优劣比较。方法我科自2008年1月至2013年3月共收治153例胆总管结石合并胆囊结石的病人,分别行内镜逆行胰胆管造影(ERCP)+腹腔镜胆囊切除术(LC)或腹腔镜胆道探查取石术(LCBDE)+LC术式治疗,并对手术时间、出血量、住院费用、术后血淀粉酶、结石残留率、术后并发症发生率等指标进行统计学分析。结果 LCBDE+LC组平均手术时间、出血量分别为103.49±22.56 min、51.04±15.05 mL,均大于ERCP+LC组(87.89±18.33 min、16.84±6.58 mL,P<0.05),术后血淀粉酶及住院费用是LCBDE+LC 组小于 ERCP+LC 组(86.23±16.58 U/L vs 303.31±46.32 U/L,21446±8739元 vs 25419±8953元,P<0.05),LCBDE+LC组的术后并发症发生率明显低于 ERCP+LC 组(5.68% vs 14.29%),中转开腹率则是高于后者(5.68% vs 0),结石残留率无显著差别(2.27% vs 1.43%)。结论 LCBDE+LC术式在术后血淀粉酶、并发症发生率、住院费用等方面较ERCP+LC为优,但在实际诊治中,应坚持个性化选择。
目的:探討膽總管結石閤併膽囊結石的兩種不同處理方法的優劣比較。方法我科自2008年1月至2013年3月共收治153例膽總管結石閤併膽囊結石的病人,分彆行內鏡逆行胰膽管造影(ERCP)+腹腔鏡膽囊切除術(LC)或腹腔鏡膽道探查取石術(LCBDE)+LC術式治療,併對手術時間、齣血量、住院費用、術後血澱粉酶、結石殘留率、術後併髮癥髮生率等指標進行統計學分析。結果 LCBDE+LC組平均手術時間、齣血量分彆為103.49±22.56 min、51.04±15.05 mL,均大于ERCP+LC組(87.89±18.33 min、16.84±6.58 mL,P<0.05),術後血澱粉酶及住院費用是LCBDE+LC 組小于 ERCP+LC 組(86.23±16.58 U/L vs 303.31±46.32 U/L,21446±8739元 vs 25419±8953元,P<0.05),LCBDE+LC組的術後併髮癥髮生率明顯低于 ERCP+LC 組(5.68% vs 14.29%),中轉開腹率則是高于後者(5.68% vs 0),結石殘留率無顯著差彆(2.27% vs 1.43%)。結論 LCBDE+LC術式在術後血澱粉酶、併髮癥髮生率、住院費用等方麵較ERCP+LC為優,但在實際診治中,應堅持箇性化選擇。
목적:탐토담총관결석합병담낭결석적량충불동처리방법적우렬비교。방법아과자2008년1월지2013년3월공수치153례담총관결석합병담낭결석적병인,분별행내경역행이담관조영(ERCP)+복강경담낭절제술(LC)혹복강경담도탐사취석술(LCBDE)+LC술식치료,병대수술시간、출혈량、주원비용、술후혈정분매、결석잔류솔、술후병발증발생솔등지표진행통계학분석。결과 LCBDE+LC조평균수술시간、출혈량분별위103.49±22.56 min、51.04±15.05 mL,균대우ERCP+LC조(87.89±18.33 min、16.84±6.58 mL,P<0.05),술후혈정분매급주원비용시LCBDE+LC 조소우 ERCP+LC 조(86.23±16.58 U/L vs 303.31±46.32 U/L,21446±8739원 vs 25419±8953원,P<0.05),LCBDE+LC조적술후병발증발생솔명현저우 ERCP+LC 조(5.68% vs 14.29%),중전개복솔칙시고우후자(5.68% vs 0),결석잔류솔무현저차별(2.27% vs 1.43%)。결론 LCBDE+LC술식재술후혈정분매、병발증발생솔、주원비용등방면교ERCP+LC위우,단재실제진치중,응견지개성화선택。
cholecysto-choledocholithiasis were treated by LCBDE (laparoscopic common bile duct exploration)+LC( laparoscopic cholecystectomy ) . or ERCP . ( endoscopic retrograde cholangio-pancreatography )+LC . The surgical time, blood loss,.postoperative blood amylase,.total expenditure,.stones clearance rate,. complication rate were compared between two groups...Results LCBDE+LC group showed better than the ERCP+LC group in postoperative blood amylase,.operation failure rate, complication rate and total expenditure (P<0.05). The latter showed better in surgery time,.estimated blood loss (P<0.05). And there were no significant difference in stones clearance rate between the two groups . (P>0.05). Conclusion In the present study,.LCBDE+LC group had more advantages than the ERCP+LC group in postoperative blood amylase,.operation failure rate,.complication rate and total expenditure,.while we should insist on personalization options in actual practice.