CAJ | 학술논문

目的：比较腹腔镜胆囊切除＋胆总管探查（LC＋LCBDE）与内镜逆行胰胆管造影/内镜下0ddi括约肌切开术（ERCP/EST）联合腹腔镜胆囊切除术（LC）治疗老年患者胆囊结石合并胆总管结石的临床效果。方法回顾性分析我院肝胆外科2010年1月到2013年1月收治的96例老年患者胆囊结石合并胆总管结石的临床资料，其中38例行 LC＋LCBDE ，58例行 EST＋LC ，对两组患者手术成功率、结石清除率、总的并发症发生率、住院时间、住院费用等进行比较分析。结果两组患者并发症发生率、结石清除率及手术成功率差距均无统计学意义（P＞0．05）， LC＋LCBDE组住院时间及费用明显低于ERCP/EST＋LC组。结论对于老年胆囊结石合并胆总管结石患者，两种手术方式都是安全有效的。对于符合条件的老年患者，LC＋LCBDE可作为主要的治疗方式。
목적：비교복강경담낭절제＋담총관탐사（LC＋LCBDE）여내경역행이담관조영/내경하0ddi괄약기절개술（ERCP/EST）연합복강경담낭절제술（LC）치료노년환자담낭결석합병담총관결석적림상효과。방법회고성분석아원간담외과2010년1월도2013년1월수치적96례노년환자담낭결석합병담총관결석적림상자료，기중38례행 LC＋LCBDE ，58례행 EST＋LC ，대량조환자수술성공솔、결석청제솔、총적병발증발생솔、주원시간、주원비용등진행비교분석。결과량조환자병발증발생솔、결석청제솔급수술성공솔차거균무통계학의의（P＞0．05）， LC＋LCBDE조주원시간급비용명현저우ERCP/EST＋LC조。결론대우노년담낭결석합병담총관결석환자，량충수술방식도시안전유효적。대우부합조건적노년환자，LC＋LCBDE가작위주요적치료방식。
Objective To evaluate the therapeutic effect of laparoscopic cholecystectomy (LC)+laparoscopic common bile duct exploration(LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST)+LC in treatment for concomitant cholecystolithiasis and choledocholithiasis in senile patients . Methods The clinical data of 96 senile patients with cholecy-stolithiasis and choledocholithiasis, who underwent surgical treatment in our hospital from January 2010 to January 2013 were retrospectively analyzed. Thirty-eight senile patients received LC+LCBDE , and the others underwent ERCP/EST+LC. The success rate of operation, the clearance rate of calculus, incidence of postoperative complications,.hospital stay,.and hospitalization charge were compared between two groups. Results There were no statistical significances in the success rate of operation , the clearance rate of calculus, and incidence of postoperative complications between two groups (P>0.05). Hospital charge and time of hospital stay were lower in LC+LCBDE group. Conclusion Both LC+LCBDE and LC+ERCP/EST are safe and effective for senile patients with cholecystolithiasis and choledocholithiasis. The LC+LCBDE is a primary choice for the appropriate cases.