腹腔镜胆囊切除术中联合ERCP治疗胆囊结石合并肝外胆管结石

Management of cholecystocholedocholithiasis by LC and intra-operative ERCP

目的:探讨腹腔镜胆囊切除(LC)术中联合ERCP治疗胆囊结石合并肝外胆管结石的临床应用价值。方法:通过分层匹配,回顾性分析LC术中及术前行ERCP治疗胆囊结石合并肝外胆管结石病例各41例,比较两组病例在手术操作时间、取石成功率、并发症发生率、住院时间、病人舒适度及住院相关费用等指标上的差异。结果:LC术中ERCP与术前ERCP具有相似的临床疗效和安全性,总体住院费用无统计学差异。虽然术中ERCP组的手术时间相对较长,但其住院时间较短,病人舒适度较好。结论:LC术中联合ERCP治疗胆囊结石合并肝外胆管结石具有较好的可行性,其应用前景值得期待。

Objective This retrospective study discussed values of the clinical application of one-stage management consisting laparoscopic cholecystectomy（LC） and endoscopic retrograde cholangiopancreatography（ERCP） to treat cholecystocholedocholithiasis.Methods All the patients suffering cholecystocholedocholithiasis receiving LC with ERCP were categorized into either intra-or pre-operative ERCP groups.With stratified matching,each group contained 41 cases.The operation time,successful stone-extraction rate,complication rate,hospitalization length,patient comfort level,and hospitalization cost between the groups were compared.Results Both groups were similar in terms of clinical efficacy,safety,and total hospitalization cost.Although the intra-operative ERCP group needed longer operation time,it was implicated of a shorter hospital stay and a higher patient comfort level.Conclusions The combination of LC and intra-operative ERCP is feasible for cholecystocholedocholithiasis during a one-stage management.A respectful future is highly anticipated.