摘要
目的探讨腹腔镜下胆总管切开术(LCBDE)与经内镜括约肌切开术(EST)治疗胆总管结石的疗效及适应证。方法回顾性分析2005年1月至2011年12月行LCBDE与EST治疗胆总管结石313例(LCBDE组188例,EST组125例)的临床资料。结果LCBDE术、EST术的手术成功率分别为98.9%、92.8%,平均住院费用分别为1.3万元、1.4万元,近期并发症发生率分别为1.6%、9.6oA,平均住院日分别为13.5d、9.8d。结论两种术式各有优缺点及其适应证。胆总管直径〉1.0cm的多发或较大结石以及中青年患者应首选LCBDE术式;而胆总管直径〈1.0cm、胆总管中下段结石或老年胆石症病人宜采用EST术式。
Objective To explore the results and indications of laparoscopic common bile duct exploration (LEBDE) vs. endoscopic sphincterotomy (EST) procedures for the management of chole- docholithiasis. Methods Of 313 cases of choledocholithiasis, 188 underwent LEBDE, and 125 under- went EST in our hospital between Jan. 2005 and Dec. 2011. Clinical data especially for treatment out- comes of both groups were analyzed retrospectively. Results For LCBDE and EST, the operation success rate was 98. 9% and 92. 8%, The average cost was 13 000 and 14 000 Yuan RMB, the incidence of the early postoperative complication was 1.6% and 9. 6%, and the average hospital stay was 13. 5 days and 9. 8 days, respectively. Conclusion There are respective indications, advantages and disad- vantages for LCBDE vs. EST. LCBDE is the better choice for patients with a CBD〉 1.0 cmin diameter and multiple choledocholithiasis, especially in young and middle-aged people. Otherwise, the better way is EST for patients with a CBD 〉1.0 cm in diameter, stones impacted in the distal CBD, or old age.
出处
《腹部外科》
2013年第1期33-35,共3页
Journal of Abdominal Surgery