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中华腔镜外科杂志(电子版) ›› 2017, Vol. 10 ›› Issue (04) : 222 -225. doi: 10.3877/cma.j.issn.1674-6899.2017.04.009

所属专题: 文献

论著

LC+LCBDE与ERCP/S+LC治疗胆囊结石合并胆总管结石的临床研究
程玉1,(), 罗云藩1, 邓予1, 罗小平1, 张胜1, 艾志国1, 饶小惠1, 黄运涛1   
  1. 1. 516001 惠州市中心人民医院肝胆外科
  • 收稿日期:2017-07-26 出版日期:2017-08-30
  • 通信作者: 程玉

Clinical study of LC+ LCBDE and ERCP/S+ LC in treating cholecystolithiasis wtih choledocholithiasis

Yu Cheng1,(), Yunfan Luo1, Yu Deng1, Xiaoping Luo1, Sheng Zhang1, Zhiguo Ai1, Xiaohui Rao1, Yuntao Huang1   

  1. 1. Department of Hepatobiliary Surgery; Huizhou Central People′s Hospital, Huizhou 516001, China
  • Received:2017-07-26 Published:2017-08-30
  • Corresponding author: Yu Cheng
  • About author:
    Corresponding author: Cheng Yu, Email:
引用本文:

程玉, 罗云藩, 邓予, 罗小平, 张胜, 艾志国, 饶小惠, 黄运涛. LC+LCBDE与ERCP/S+LC治疗胆囊结石合并胆总管结石的临床研究[J/OL]. 中华腔镜外科杂志(电子版), 2017, 10(04): 222-225.

Yu Cheng, Yunfan Luo, Yu Deng, Xiaoping Luo, Sheng Zhang, Zhiguo Ai, Xiaohui Rao, Yuntao Huang. Clinical study of LC+ LCBDE and ERCP/S+ LC in treating cholecystolithiasis wtih choledocholithiasis[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2017, 10(04): 222-225.

目的

研究两种微创手术[腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC) +腹腔镜胆总管探查切开取石术(laparoscopic common bile duct exploration and stone extraction,LCBDE)和内镜下逆行性胆胰管造影术(endoscopic retrograde cholangiopancreatography,ERCP)/内镜下括约肌切开取石术(endoscopic sphincterotomy,EST) +LC]在治疗胆囊结石合并胆总管结石疾病中的临床应用。

方法

回顾性分析惠州市中心人民医院2010年1月至2015年12月收治的184例胆囊结石合并胆总管结石患者的临床资料,按照手术方式不同分为两组,LC+LCBDE组(59例)和ERCP/S+LC组(125例),比较分析两组患者的住院时间、住院费用,结石取净率、并发症发生率、中转开腹率。

结果

两组患者的住院时间、住院费用存在显著性差异[(13.12 ± 6.47)d vs (11.40 ± 6.83)d、(27 956.24 ± 9 896.90)元vs (35 381.35 ± 8 571.20)元,P<0.05];但是两组患者术后住院时间无显著性差异。LC+LCBDE组的住院时间长于ERCP+LC组,住院费用低于ERCP/S+LC组,并发症发生率、但结石清除率、中转开腹率两组无明显差异。

结论

对于胆囊结石合并胆总管结石,LC+LCBDE与ERCP/S都是安全有效的手术方式。但两者皆需改进。LC+LCBDE需要减少住院时间,ERCP/S+LC需要减少住院费用。

Objective

To compare therapeutic effects of laparoscopic cholecystectomy plus laparoscopic common bile duct exploration(LC+ LCBDE) and endoscopic retrograde cholangiopancreatography(ERCP)and sphincterotomy (EST) with stone extraction plus laparoscopic cholecystectomy(ERCP/S+ LC) in treating cholecystolithiasis with choledocholithiasis.

Methods

From Jan. 2010 to Dec.2015, 184 patients with cholecystolithiasis and choledocholithiasis were admitted to our hospital. According to different surgical procedure, they were divided into two groups: LC+ LCBDE group with 59 patients and ERCP/S+ LC group with 125 patients. Several indexes including hospital stay time, hospital charges, rate of complications, efficacy of stone clearance, rate of conversion to open procedures were comparatively analyzed in these two groups.

Results

There was statistically significant difference between the LC+ LCBDE and ERCP/S+ LC groups in total hospital stay time and total hospital charges[(13.12 ± 6.47)d vs (11.40 ± 6.83)d, (27 956.24 ± 9 896.90)yuan vs (35 381.35 ± 8 571.20)yuan, P< 0.05]. But there was no statistically significant difference in postoperative hospital stay time and efficacy of stone clearance, rate of complications, and rate of conversion to open procedures. The total hospital stay time of LC+ LCBDE group was longer than that of ERCP/S+ LC group. And the total hospital charges of LC+ LCBDE group was less than that of ERCP/S+ LC group.

Conclusions

Both LC+ LCBDE and ERCP/S+ LC were safe and effective in treating cholecystolithiasis with choledocholithiasis. There was little advantage for LC+ LCBDE with the routine placement of T tube in common bile duct compared with ERCP/S+ LC. But both procedure need improvement. LC+ LCBDE procedure need decrease its total hospital stay time and ERCP/S+ LC procedure need decrease its total hospital charges.

表1 胆囊结石合并胆总管结石患者的两组临床资料比较
表2 胆囊结石合并胆总管结石患者的两组临床指标比较
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