摘要：目的：评价腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)和内镜下Oddi括约肌切开取石术(endoscopic sphincterotomy,EST)联合治疗胆囊和胆管结石病的方法和价值。方法：对40例经B超或CT、MRCP检查证实为胆囊结石合并胆总管结石病人先行EST取石再行LC。结果：40例病人完成EST取石和39例病人完成LC，1例中转进腹，1例LC后经鼻胆管造影见结石残留后再次内镜取石。结论：联合应用LC和EST治疗胆囊结石合并胆总管结石是一种安全有效的治疗方法。

    关键词：胆结石；胆总管结石；腹腔镜胆囊切除术；内镜括约肌切开

    LC Combined with EST in Treating Cholecystolithiasis with Common Bile Duct Stones

    ZHANG Hui,CHANG Qi-meng,DING Jun-ling,et al

    (Changning District Central Hospital, Shanghai 200336, China)

    Abstract： Objective: To evaluate the technique and value of the combination of laparoscopic cholecystestomy(LC) and endoscopic sphincterotomy(EST) in the treatment of cholecystolithiasis and common bile duct stones(CBD). Method: 40 patients diagnosed as cholecystolithiasis with common bile duct stones by B-ultrasonography or computer tomography(CT) and MRCP underwent LC following EST. Result: 40 cases of patients succeeded in EST , among which 39 cases underwent LC successfully, while one case was conversed to laparotomy. One case of residual stone comformed by nasol-biliary tract opacifiacion after LC accepted a second time endoscopic stone removement. Conclusion: Combination of laparoscopic and endoscopic procedure is a safe and effective method to treat the patients suffering from cholelith of the gallbladder and CBD. ......