微创手术治疗胆囊结石合并胆总管结石的临床疗效分析(1)
摘 要：目的 分析腹腔镜胆囊切除(LC)+胆总管探查取石术(LCBDE)与腹腔镜胆囊切除(LC)+十二指肠镜Oddi括约肌切开术(EST)/逆行性胰胆管造影(ERCP)的临床疗效。方法 回顾性分析2016年2月～2017年2月收治的胆囊结石合并胆总管结石患者120例，按照不同治疗方式分为两组，对照组60例行LC+EST/ERCP，观察组60例行LC+LCBDE，观察两组患者的手术成功率、术中出血量、术后住院时间、住院费用、术后并发症发生率安全性和可行性。结果 两组患者手术成功率、并发症发生率、出血量差异均无统计学意义(P>0.05)。观察组住院时间、住院费用均低于对照组，差异有统计学意义(P<0.05)。结论 LC+LCBDE与LC+EST/ERCP均是安全有效治疗胆囊合并胆管结石的手术方式，在术中出血量、术后住院时间、住院费用方面LC+LCBDE占优势，临床根据患者情况行个体化治疗，灵活选取手术方式。
关键词：微创；胆囊结石；胆总管结石
中图分类号：R657.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.02.038
, 百拇医药
文章編号：1006-1959(2018)02-0107-02
Abstract：Objective To analyze the relationship between laparoscopic cholecystectomy(LC)+choledocholithotomy(LCBDE)and laparoscopic cholecystectomy(LC)+duodenoscopy Oddi sphincterotomy(EST)/retrograde cholangiopancreatography(ERCP)clinical efficacy.Methods A retrospective analysis of 120 patients with cholecystolithiasis and choledocholithiasis admitted between February 2016 and February 2017，according to different treatment methods，the patients were divided into two groups.The control group of 60 patients underwent LC+EST/ERCP.The observation group of 60 patients underwent LC+LCBDE.Observe two groups of patients with the success rate of surgery，intraoperative bleeding， postoperative hospitalization time， cost of hospitalization，the incidence of the feasibility and safety of postoperative complications.Results Two groups of patients with operation success rate，complication rate，the amount of bleeding had no statistically significant difference(P>0.05).The observation group hospitalization time， hospitalization expenses were lower than the control group，the difference was statistically significant(P<0.05).Conclusion LC+LCBDE and LC+EST/ ERCP are safe and effective surgical treatment of gallbladder with bile duct stones，LC+LCBDE in the blood loss， postoperative hospital stay， hospitalization costs advantage，the clinical treatment of patients based on individualized treatment，flexible selection of surgical methods.
, 百拇医药
Key words：Minimally invasive；Cholecystolithiasis；Choledocholith
胆囊结石合并胆总管结石是一种常见的胆囊病症，采用胆囊切除术对进行治疗是目前临床上最为有效的治疗手段[1]。腹腔镜技术逐渐的成熟，并具有创伤小、并发症少、患者痛苦少等优点，受到广泛青睐。目前常用的微创术式主要有两种：①腹腔镜胆囊切除(LC)+胆总管探查取石术(LCBDE)；②腹腔镜胆囊切除(LC)+十二指肠镜Oddi括约肌切开术(EST)/逆行性胰胆管造影(ERCP)。本研究选择我院收治的胆囊结石合并胆总管结石患者作为研究对象进行研究，取得了一定的成效，现报道如下。
1资料与方法
1.1一般资料 回顾性分析我院2016年2月～2017年2月收治的120例胆囊结石合并胆总管结石患者，入院后行腹部CT、超声、磁共振胆胰管造影(MRCP)等检查，均明确诊断胆囊结石合并胆总管结石，患者及家属知情同意，排除肝内胆管结石。所有患者依不同治疗方式分为对照组和观察组各60例。对照组男38例，女22例；年龄53～73岁，平均年龄(60.21±6.97)岁，结石直径(7.14±1.54)mm，胆总管直径(10.25±2.04)mm；合并基础疾病：原发性高血压39例，高脂血症35例，糖尿病14例。观察组男40例，女20例；年龄55～75岁，平均年龄(62.11±7.34)岁，结石直径(6.73±1.93)mm，胆总管直径(10.1±1.72)mm；合并基础疾病：原发性高血压35例，高脂血症40例，糖尿病17例。两组患者一般资料比较差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(任海滨)
关键词：微创；胆囊结石；胆总管结石
中图分类号：R657.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.02.038
, 百拇医药
文章編号：1006-1959(2018)02-0107-02
Abstract：Objective To analyze the relationship between laparoscopic cholecystectomy(LC)+choledocholithotomy(LCBDE)and laparoscopic cholecystectomy(LC)+duodenoscopy Oddi sphincterotomy(EST)/retrograde cholangiopancreatography(ERCP)clinical efficacy.Methods A retrospective analysis of 120 patients with cholecystolithiasis and choledocholithiasis admitted between February 2016 and February 2017，according to different treatment methods，the patients were divided into two groups.The control group of 60 patients underwent LC+EST/ERCP.The observation group of 60 patients underwent LC+LCBDE.Observe two groups of patients with the success rate of surgery，intraoperative bleeding， postoperative hospitalization time， cost of hospitalization，the incidence of the feasibility and safety of postoperative complications.Results Two groups of patients with operation success rate，complication rate，the amount of bleeding had no statistically significant difference(P>0.05).The observation group hospitalization time， hospitalization expenses were lower than the control group，the difference was statistically significant(P<0.05).Conclusion LC+LCBDE and LC+EST/ ERCP are safe and effective surgical treatment of gallbladder with bile duct stones，LC+LCBDE in the blood loss， postoperative hospital stay， hospitalization costs advantage，the clinical treatment of patients based on individualized treatment，flexible selection of surgical methods.
, 百拇医药
Key words：Minimally invasive；Cholecystolithiasis；Choledocholith
胆囊结石合并胆总管结石是一种常见的胆囊病症，采用胆囊切除术对进行治疗是目前临床上最为有效的治疗手段[1]。腹腔镜技术逐渐的成熟，并具有创伤小、并发症少、患者痛苦少等优点，受到广泛青睐。目前常用的微创术式主要有两种：①腹腔镜胆囊切除(LC)+胆总管探查取石术(LCBDE)；②腹腔镜胆囊切除(LC)+十二指肠镜Oddi括约肌切开术(EST)/逆行性胰胆管造影(ERCP)。本研究选择我院收治的胆囊结石合并胆总管结石患者作为研究对象进行研究，取得了一定的成效，现报道如下。
1资料与方法
1.1一般资料 回顾性分析我院2016年2月～2017年2月收治的120例胆囊结石合并胆总管结石患者，入院后行腹部CT、超声、磁共振胆胰管造影(MRCP)等检查，均明确诊断胆囊结石合并胆总管结石，患者及家属知情同意，排除肝内胆管结石。所有患者依不同治疗方式分为对照组和观察组各60例。对照组男38例，女22例；年龄53～73岁，平均年龄(60.21±6.97)岁，结石直径(7.14±1.54)mm，胆总管直径(10.25±2.04)mm；合并基础疾病：原发性高血压39例，高脂血症35例，糖尿病14例。观察组男40例，女20例；年龄55～75岁，平均年龄(62.11±7.34)岁，结石直径(6.73±1.93)mm，胆总管直径(10.1±1.72)mm；合并基础疾病：原发性高血压35例，高脂血症40例，糖尿病17例。两组患者一般资料比较差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(任海滨)