EST联合LC治疗胆囊结石合并肝外胆管结石

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

目的探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)和内镜下Oddi括约肌切开取石术(endoscopic sphincterotomy,EST)在治疗胆囊结石合并肝外胆管结石中的临床应用价值。方法对62例胆囊结石合并肝外胆管结石的患者先行EST,然后行LC。结果 2例因EST取石失败而改开腹手术,其余60例获得成功,无肠穿孔、胆漏等严重并发症发生。8例出现一过性血淀粉酶升高,4例出现肠道出血,均经保守治疗后治愈。结论 EST联合LC治疗胆囊结石合并肝外胆管结石是一种安全有效的治疗模式。

Objective To explore the value of the combination of endoscopic sphincterotomy （EST） and laparoscopic cholecystestomy （LC） in the treatment of Cholecystolithiasis with extraheptatic bile duct stones. Methods 62 cases with cholecystolithiasis combined with extraheptatic bile duct stones were underwent LC following EST. Results Two cases were treated with common bile duct exploration after the failure of EST. 60 cases were executed sucessfully by EST and LC. No case occured serious complications. 8 patients with transient hyperamylasemia and 4 cases with intestinal bleeding after operation were cured by means of conservative therapy. Conclusion Combination of EST and LC is a safe and effective method in the treatment of cholecystolithiasis with extraheptatic bile duct stones.