The comparision of ERCP and laparoscopic common bile duct exploration to treat gallbladder stones combined with common bile duct stones

doi:10.3877/cma.j.issn.1674-6899.2016.01.010

Abstract

Abstract:

Objective

To compare the advantages and disadvantages of ERCP and laparoscopic common bile duct exploration for the treatment of gallbladder stones combined with common bile duct stones.

Methods

The therapeutic results of 197 cases who underwent ERCP or LCBDE were reviewed retrospectively to find out the advantages and disadvantages of the two operations.

Results

There are 6 cases operation failure, 32 cases acute pancreaitis, 1 case duodenum perforation and 3 cases common bile duct stones recurrence in the ERCP group(99 cases). There are no operation failure, 8 cases with T-tube drainage , no serious complications and no bile duct stones recurrence in the LCBDE group(98 cases). The hospital stay time and hospital costs of LCBDE group is lower than the ERCP group[(5± 2) d vs (3±1)d, (2.23±0.85) Million yuan vs (1.73± 0.43) Million yuan].

Conclusions

The ERCP and LCBDE are effective methods for the treatment of Gallbladder stones combined with common bile duct stones. For most patients, the LCBDE is the first choice method, and for some special patient , ERCP is a good choice.

Key words: Gallbladder stones, Common bile duct stones, Laparoscopy, Gommon bile duct exploration, Endoscopic retrograde cholangiopancreatography, Endoscopic sphincterotomy

Xianglong Tan, Ruihua Xue, Dadong Wang. The comparision of ERCP and laparoscopic common bile duct exploration to treat gallbladder stones combined with common bile duct stones[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(01): 37-40.

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References 15

1	吕富靖，张澍田，冀明等. 三镜联合"一步法"治疗胆总管结石合并胆囊结石的临床疗效观察[J]. 中华消化内镜杂志，2015，32 (5): 277-280.
2	Zhang WJ, Xu GF, Huang Q, et al. Treatment of gallbladder stone with common bile duct stones in the laparoscopic era[J]. BMC Surg, 2015, 15(1): 7.
3	Yin Z, Xu K, Sun J, et al. Is the end of the t-tube drainage era in laparoscopic choledochotomy for common bile duct stones is coming? a systematic review and meta-analysis[J]．Ann Surg, 2013, 257(1): 54-66.
4	Samardzic J, Latic F, Kraljik D, et al. Treatment of common bile duct stones--is the role of ERCP changed in era of minimally invasive surgery[J]. Med Arh, 2010, 64(3): 187-188.
5	牛军，牛卫博，张朝阳，等. 腹腔镜胆总管切开取石T管引流术：15年经验回顾与展望[J]. 中国现代普通外科进展，2007，10(2): 108-111.
6	所广军，徐安，胡海. ERCP临床应用指征探讨[J]. 中国普外基础与临床杂志，2011，18(5): 533-536.
7	黎明，王浩，王佐正，等. 十二指肠乳头旁憩室与胆胰疾病的关系[J]. 宁夏医科大学学报，2014，36(11): 1244-1246.
8	Lu J, Cheng Y, Xiong XZ, et al. Two-stage vs single-stage management for concomitant gallstones and common bile duct stones[J]. World J Gastroenterol, 2012, 18(24): 3156-3166.
9	Grande M, Torquati A, Tucci G, et al. Preoperative risk factors for common bile duct stones: defining the patient at high risk in the laparoscopic cholecystectomy era[J]. J Laparoendosc Adv Surg Tech A, 2004, 14(5): 281-286.
10	高卫东，姚礼庆，何国杰，等. 急性胆源性胰腺炎的急诊内镜治疗[J]. 中国内镜杂志，2002，8(9): 25-27.
11	Yokoe M, Takada T, Mayumi T, et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015[J]. J Hepatobiliary Pancreat Sci, 2015, 22(6): 405-432.
12	Bin OY, Zeng KW, Hua HW, et al. Endoscopic nasobiliary drainage and percutaneous transhepatic biliary drainage for the treatment of acute obstructive suppurative cholangitis: a retrospective study of 37 cases[J]. Hepatogastroenterology, 2012, 59(120): 2454-2456.
13	齐伟，钱小星. 急性胆源性胰腺炎的早期内镜治疗与保守治疗的对比分析[J]. 肝胆外科杂志，2013，21(6): 432-434.
14	张利霞，沈云志. 急性胆管炎的诊断与非手术治疗进展[J]. 国际消化病杂志，2008，28(5): 418-420.
15	Dasari BV, Tan CJ, Gurusamy KS, et al. Surgical versus endoscopic treatment of bile duct stones[CD]. Cochrane Database Syst Rev, 2013, 12: CD003327.

项目	ERCP组(99例)	LCBDE组(98例)
性别(男∶女)	43∶56	42∶56
年龄(岁)	54.7 ± 8.9	61.8 ± 9.9^a
合并胰腺炎(例)	20	10^a
合并急性胆管炎(例)	35	40^a

项目	ERCP组(99例)	LCBDE组(98例)
性别(男∶女)	43∶56	42∶56
年龄(岁)	54.7 ± 8.9	61.8 ± 9.9^a
合并胰腺炎(例)	20	10^a
合并急性胆管炎(例)	35	40^a

项目	ERCP组(99例)	LCBDE组(98例)
手术失败(例)	6	0^a
残余结石或结石复发(例)	3	0^a
手术后合并胰腺炎(例)	32	0^a
术后平均住院时间(d)	5 ± 2	3 ± 1^a
平均住院费用(万元)	2.23 ± 0.85	1.73 ± 0.43^a
术后平均带管时间(d)	4 ± 2	3 ± 1^a
严重并发症(十二指肠壁穿孔，例)	1	0^a

项目	ERCP组(99例)	LCBDE组(98例)
手术失败(例)	6	0^a
残余结石或结石复发(例)	3	0^a
手术后合并胰腺炎(例)	32	0^a
术后平均住院时间(d)	5 ± 2	3 ± 1^a
平均住院费用(万元)	2.23 ± 0.85	1.73 ± 0.43^a
术后平均带管时间(d)	4 ± 2	3 ± 1^a
严重并发症(十二指肠壁穿孔，例)	1	0^a

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