中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
18期
2721-2723
,共3页
胆囊结石病%胆总管结石%胆囊切除术,腹腔镜
膽囊結石病%膽總管結石%膽囊切除術,腹腔鏡
담낭결석병%담총관결석%담낭절제술,복강경
Cholecystolithiasis%Choledocholithiasis%Cholecystectomy,Laparoscopic
目的：比较腹腔镜胆囊切除术联合腹腔镜胆总管切开取石（LCBDE）与内镜下括约肌切开取石术联合腹腔镜胆囊切除术（ERCP／S ＋LC）治疗胆囊结石合并胆总管结石的疗效。方法回顾性分析280例胆囊结石合并胆总管结石患者的资料，根据治疗方案分为 LCBDE 组（A 组60例）和 ERCP／S ＋LC 组（B 组220例）。比较两种治疗方法的疗效。结果A、B 两组手术用时、术后住院时间、住院费用、胆总管结石大小、结石清除率、术后并发症发生率分别为（95．58±22．66）min、（87．46±40．25）min、（15．18±5．46）d、（14．32±4.21）d、（2．45±0．32）万元、（2．89±0．64）万元，（1．12±0．34）cm、（1．39±0．38）cm、96．6％、91．0％，1．6％、3．2％。两组手术结石清除率差异无统计学意义（χ2＝1．44，P ＞0．05），LCBDE 组的住院费用略低于 ERCP／S＋LC 组，但差异无统计学意义（t ＝0．923，P ＞0．05）。ERCP／S ＋LC 组术后并发症发生率要高于 LCBDE 组，差异有统计学意义（χ2＝4．17，P ＜0．05）。结论LCBDE 和 ERCP／S ＋LC 均是治疗胆囊结石合并胆总管结石的有效微创疗法，在临床上应根据患者实际情况选择使用。
目的：比較腹腔鏡膽囊切除術聯閤腹腔鏡膽總管切開取石（LCBDE）與內鏡下括約肌切開取石術聯閤腹腔鏡膽囊切除術（ERCP／S ＋LC）治療膽囊結石閤併膽總管結石的療效。方法迴顧性分析280例膽囊結石閤併膽總管結石患者的資料，根據治療方案分為 LCBDE 組（A 組60例）和 ERCP／S ＋LC 組（B 組220例）。比較兩種治療方法的療效。結果A、B 兩組手術用時、術後住院時間、住院費用、膽總管結石大小、結石清除率、術後併髮癥髮生率分彆為（95．58±22．66）min、（87．46±40．25）min、（15．18±5．46）d、（14．32±4.21）d、（2．45±0．32）萬元、（2．89±0．64）萬元，（1．12±0．34）cm、（1．39±0．38）cm、96．6％、91．0％，1．6％、3．2％。兩組手術結石清除率差異無統計學意義（χ2＝1．44，P ＞0．05），LCBDE 組的住院費用略低于 ERCP／S＋LC 組，但差異無統計學意義（t ＝0．923，P ＞0．05）。ERCP／S ＋LC 組術後併髮癥髮生率要高于 LCBDE 組，差異有統計學意義（χ2＝4．17，P ＜0．05）。結論LCBDE 和 ERCP／S ＋LC 均是治療膽囊結石閤併膽總管結石的有效微創療法，在臨床上應根據患者實際情況選擇使用。
목적：비교복강경담낭절제술연합복강경담총관절개취석（LCBDE）여내경하괄약기절개취석술연합복강경담낭절제술（ERCP／S ＋LC）치료담낭결석합병담총관결석적료효。방법회고성분석280례담낭결석합병담총관결석환자적자료，근거치료방안분위 LCBDE 조（A 조60례）화 ERCP／S ＋LC 조（B 조220례）。비교량충치료방법적료효。결과A、B 량조수술용시、술후주원시간、주원비용、담총관결석대소、결석청제솔、술후병발증발생솔분별위（95．58±22．66）min、（87．46±40．25）min、（15．18±5．46）d、（14．32±4.21）d、（2．45±0．32）만원、（2．89±0．64）만원，（1．12±0．34）cm、（1．39±0．38）cm、96．6％、91．0％，1．6％、3．2％。량조수술결석청제솔차이무통계학의의（χ2＝1．44，P ＞0．05），LCBDE 조적주원비용략저우 ERCP／S＋LC 조，단차이무통계학의의（t ＝0．923，P ＞0．05）。ERCP／S ＋LC 조술후병발증발생솔요고우 LCBDE 조，차이유통계학의의（χ2＝4．17，P ＜0．05）。결론LCBDE 화 ERCP／S ＋LC 균시치료담낭결석합병담총관결석적유효미창요법，재림상상응근거환자실제정황선택사용。
Objective To compare the effect of endoscopic retrograde cholangiopancreatography sphincterot-omy plus laparoscopic cholecystectomy(ERCP/S +LC)and laparoscopic common bile duct exploration(LCBDE)in the treatment of cholecystolithiasis patients with concurrent choledocholith.Methods Retrospective analysis was made of information of 280 cholecystolithiasis patients with concurrent choledocholith,who were randomly divided into group A (n =60)and group B (n =220).group A was arranged with LCBDE and group B was treated ERCP/S +LC. The operation time,hospital stay after operation,hospitalization fee,size of common bile duct calculi,stone clearance rate and the incidence of postoperative complications were compared.Results The operation time,hospital stay after operation,hospitalization fee,size of the common bile duct calculi,stone clearance rate and the incidence of postopera-tive complications of group A &B were (95.58 ±22.66)m vs.(87.46 ±40.25)m,(15.18 ±5.46)d vs.(14.32 ± 4.21)d,(2.45 ±0.32)ten thousand yuan vs.(2.89 ±0.64)ten thousand yuan,(1.12 ±0.34)cm vs.(1.39 ± 0.38)cm,96.6% vs.91% and 1.6% vs.3.2%.There was no significant difference in calculus clearance rate between the two treatments(χ2 =1.44,P >0.05 ).Patients in LCBDE group spent slightly less on hospitalization expenses than patients in ERCP/S +LC group,but there was no significant difference shown(t =0.923,P >0.05). Patients in ERCP/S +LC group had suffered a relatively high incidence of complications than patients in LCBDE group,and significant difference was found(χ2 =4.17,P <0.05).Conclusion Both LCBDE and ERCP/S +LC are effective minimally invasive therapies for concurrent cholecystolithiasis and choledocholith,and should be clinically applied in accordance with their specific characteristics.
