两种胆囊切除术式对胆囊结石合并胆总管结石的比较研究

Comparison between two cholecystectomies for cholecystolithiasis with choledocholithiasis

目的探讨两种胆囊切除术治疗方法对胆囊结石合并胆总管结石的治疗效果。方法回顾性分析2006年6月～2008年3月该院86例胆囊结石合并胆总管结石患者,其中44例行LC、胆总管探查、一期缝合术(A组);42例行EST取石联合LC(B组)。结果A组住院时间、术后用药时间明显少于B组(P<0.05),两组患者术后并发症的发生率比较差异无显著性。结论腹腔镜下胆管探查、取石,取净结石后一期缝合胆总管,可作为治疗胆囊结石合并胆总管结石的一种安全、有效的方法。

[Objective] To compare the effect between two kinds of cholecystectomy for cholecystolithiasis with choledocholithiasis. [Methods] From June 2006 to March 2008, 86 cases with both cholecystolithiasis and choledocholithiasis were treated by cholecystectomy in our hospital, including 44 cases by laparoscopic cholecystectomy and common bile duct exploration with primary suture （group A）, and 42 cases by endoscopic sphincterotomy and laparoscopic cholecystectomy （group B）. [Results] The average hospital stay and medication time after surgery in group A was shorter than those in group B （P 〈0.05）. There was no significant difference in morbidity and mortality after surgery between group A and group B. [Conchtsions] The primary suture after laparoscopic common bile duct exploration and choledochotomy could avoid the disturbance of biliary function and electrolyte imbalance, and it would be a safe and effective method for cholecystolithiasis with choledocholithiasis