经内镜乳头括约肌切开取石术与传统开腹胆总管切开取石术治疗胆总管结石的疗效比较

The clinical effect between open choledocholithoyomy and endoscopic sphincterotomy( EST) in the treatment of common bile duct stones

目的探讨经内镜乳头括约肌切开取石术与传统开腹胆总管切开取石术治疗胆总管结石的临床疗效。方法选择我院2010年6月至2013年1月行手术治疗胆总管结石患者70例,其中行内镜乳头括约肌切开取石术35例作为治疗组,开腹胆总管切开取石手术治疗35例作为对照组。观察并比较两组临床疗效结果。结果 70例手术均获成功。其中观察组在手术时间、引流时间、术后下床活动时间、术后排气恢复时间、术后住院天数、术后并发症发生率方面均优于对照组(P<0.05)。结论经内镜乳头括约肌切开术治疗胆总管结石具有创伤小、术后恢复快、痛苦少、住院时间短及术后并发症少等优点,是目前治疗胆总管结石的理想微创术式之一,临床上值得推广应用。

Objective To investigate the clinical effect between open choledocholithoyomy and endoscopic sphincterotomy （EST） in the treatment of common bile duct stones. Methods 70 patients diagnosed as choledocholithiasis in our hospital from June 2010 to January 2013 were selected into treatment group and control group. 35 cases in treatment group were treated with endoscopic sphincterotomy, 35 cases in control group were received conventional open choledocholithoyomy surgery. The clinical effect were ob- served and compared by the two groups. Results The operations were successful in all the 70 cases. Compared with the control group, patients treated with EST had a shorter operation time, shorter drainage time, earlier postoperative ambulation, quicker postop- erative intestinal exhaust time shorter postoperative hospitalization stay and little the incidence rate of postoperative complications （P 〈 0.05）. Conclusion EST in the treatment of common bile duct stones has its advantages as minimal injury, quick recovery, less pain, shorter hospitalization time and fewer postoperative complications and it＇ s ideal for minimally invasive surgical approach, worthy of clinical application.