EST联合LC治疗胆囊并胆总管结石(附73例病例报告)

Therapy of choleystolithiasis and common bile duct calculus with endoscopic sphincterotomy (EST) and laparoscopic cholecystectomy (LC) (report of 73 cases)

目的探讨十二指肠镜乳头括约肌切开术(EST)联合腹腔镜胆囊切除术(LC)治疗胆囊并胆总管结石的临床疗效。方法38例患者常规行内镜胰胆管逆行造影术(ERCP)发现胆总管结石后,即行EST+网篮取石。根据EST术后并发症治愈的情况再行LC。结果全部病例EST均获成功,结石全部取出,术后出现胰腺炎1例,胆管炎2例,治疗1周痊愈后行LC术。结论EST联合LC治疗胆囊并胆总管结石具有创伤小、效果好、并发症少、恢复快等优点,该微创治疗方法扩大了LC的指征,可在临床推广应用。

[Objective] To detect the clinic effect of choleystolithiasis and common bile duct calculus with Endoscopic sphincterotomy （EST） and Laparoscopic cholecystectomy （LC）. [Methods] 38 cases in the associated group were performed Endoscopic Retrograde Cholangiopancreatography （ERCP） and followed by EST and basket net lithotomy. Then according to the healing of complication, LC was made. [Results] All patients were operated successfully and the calculus was removed completed. The one patient with pancreatitis and two patients with cholangitis after EST were treated by LC successfully after 1 week of treatment. [Conclusions] EST associated with LC is a micro-trauma management. It has many advantages such as little trauma, good effects, less complication and rapid recovery, and could be applied in clinic.