CAJ | 학술논문

目的比较内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)技术与开腹手术治疗胆总管结石的临床价值.方法回顾分析在我院就诊且初次诊断为胆总管结石的患者,经ERCP技术治疗者56例(内镜组),经开腹胆道探查取石治疗者78例(开腹组),比较2组患者的取石成功率、手术时间、术中出血量、感染率、胰腺炎发生率、高淀粉酶血症发生率、胆总管结石复发率、住院时间、住院费用等指标,并对结果进行统计学分析.结果内镜组的手术时间、解除梗阻时间、术中出血量、感染率、住院时间低于开腹组,内镜组的高淀粉酶血症发生率、住院费用高于开腹组,差异有统计学意义;内镜组的取石成功率低于开腹组,内镜组胰腺炎发生率、胆总管结石复发率高于开腹组,差异无统计学意义.结论 ERCP技术治疗胆总管结石较开腹手术治疗手术时间短,术中出血量少,术后感染率低,住院时间短,但高淀粉酶血症发生率高,住院费用高.
목적 비교내경역행이담관조영(endoscopic retrograde cholangiopancreatography,ERCP)기술여개복수술치료담총관결석적림상개치.방법 회고분석재아원취진차초차진단위담총관결석적환자,경ERCP기술치료자56례(내경조),경개복담도탐사취석치료자78례(개복조),비교2조환자적취석성공솔、수술시간、술중출혈량、감염솔、이선염발생솔、고정분매혈증발생솔、담총관결석복발솔、주원시간、주원비용등지표,병대결과진행통계학분석.결과 내경조적수술시간、해제경조시간、술중출혈량、감염솔、주원시간저우개복조,내경조적고정분매혈증발생솔、주원비용고우개복조,차이유통계학의의;내경조적취석성공솔저우개복조,내경조이선염발생솔、담총관결석복발솔고우개복조,차이무통계학의의.결론 ERCP기술치료담총관결석교개복수술치료수술시간단,술중출혈량소,술후감염솔저,주원시간단,단고정분매혈증발생솔고,주원비용고.
Objective To compare the value of ERCP plus EST and laparotomy in the treatment of common bile duct stones.Methods 56 cases of common bile duct stones were treated with ERCP and EST in our hospital from June 2012 to June 2013 (endoscopy group),78 cases were treated with laparotomy and common bile duct exploration (laparotomy group).The two groups were compared on success rate of stone removal,operation time,intraoperative bleeding volume,incidence of infection and pancreatitis and hyperamylasemia,common bile duct stone recurrence rate,hospital stays,hospital costs.Results Operation time,intraoperative bleeding volume and infection rate in endoscopic group was lower than the laparotomy group,the incidence of hyperamylasemia,hospital costs in the endoscopic group was higher than laparotomy group.The success rate of stone removal and the recurrence rate of common bile duct stone in the endoscopic group was lower than the laparotomy group,incidence of pancreatitis in the endoscopic group was higher than the laparotomy group,though the differences were not statistically significant.Conclusions ERCP and EST is a time saving procedure fast relieving the bile duct obstruction,less traumative,spelling lower infection rate,less hospital stays,though causing higher incidence of hyperamylasemia and hospital costs.