腹腔镜胆囊切除联合胆总管探查治疗胆囊并胆总管结石的临床研究

Clinical research of gallbladder and common bile duct stones treated by LC and LCBDE

目的探讨腹腔镜胆囊切除(LC)联合胆总管探查治疗胆囊合并胆总管结石的临床效果。方法选择3年间治疗的胆总管合并胆囊结石患者132例,随机分为观察组和对照组,观察组采用LC+胆总管探查(LCBDE)治疗,对照组采用LC+内镜下括约肌切开胆管内结石(EST)治疗,比较两组患者的手术成功率、术后并发症发生率、残余结石率等指标。结果观察组手术成功率为97.22%,与对照组(96.67%)比较无统计学差异(P>0.05);观察组术后并发症发生率为1.39%,残余结石率为2.78%,均显著低于对照组(分别为3%及8.33%,均P<0.01)。结论 LC联合胆总管探查治疗胆囊合并胆总管结石不仅手术成功率与LC+EST相当,而且具有并发症少,安全性高及残余结石率低的优点。

Objective To explore the clinical effect of gallbladder and common bile duct stones treated by Laparoscopic Cholecystectomy（LC） and common bile duct exploration（LCBDE）.Methods One hundred and thirty-two cases of gallbladder and common bile duct stones were divided into LC＋LCBDE group（n=72） and LC ＋ EST control group（n=60） randomly according to the treatment mothods.The clinical date of 2 groups was compared with the rate of success of operation,incidence of postoperative complications,incidence of residual calculus,time of defecation after operation.Results There were no statistical difference of the rate of success operation between LC＋LCBDE group and EST＋LC group（P〉0.05）,but incidence of postoperative complications and residual calculus in LC＋LCBDE group were significant lower than those in LC＋EST group.Conclusions Combining LC with LCBDE is a feasible treatment for cholecystolithiasis and choledocholithiasis.