两种术式在治疗老年患者胆囊结石合并胆总管结石中的应用体会

Experience of LC+LCBDE and ERCP+LC for cholelithiasis associated with choledocholithiasis in senile patients

目的探讨腹腔镜胆囊切除术(LC)+胆总管探查术(LCBDE)与逆行胰胆管造影(ERCP)+腹腔镜胆囊切除术(LC)治疗胆囊结石合并胆总管结石的老年患者的临床效果及术式选择。方法回顾分析该院2004年1月～2010年1月施行的LC+LCBDE病例117例和ERCP+LC病例176例老年患者的临床资料,对手术疗效、住院时间及住院费用进行对比分析。结果两种治疗方式在治疗效果及住院时间上差异无显著性,但在住院费用上,ERCP+LC组较LCBDE组高,差异有显著性。结论对于有胆囊结石合并胆总管结石的老年患者,在符合ERCP适应证的前提下,ERCP+LC是同样有效安全的治疗方案。

[Objective] To study the curative effect and the surgical choice of LC＋LCBDE and ERCP＋LC for cholelithiasis associated with choledocholithiasis in senile patients.[Methods] The clinical data of 117 cases of LCBDE and 176 cases of ERCP＋LC performed in our hospital from January 2004 to January 2010 were analyzed retrospectively.[Results] Compared with the method of LCBDE,hospital cost was higher,but there was no difference in the surgical outcomes and hospital stay.[Conclusion] ERCP＋LC is a feasible and safe method as LC＋LCBDE for cholelithiasis associated with choledocholithiasis in selected senile patients.