胆总管结石的内镜及开腹手术治疗的疗效分析

The curative effect analysis of the endoscopic and open operation treatment of common bile duct calculi

目的总结并分析行内镜下逆行胰胆管造影技术(ERCP)联合经内镜十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)及开腹手术治疗胆总管结石的疗效评价。方法收集行ERCP+EST诊治的胆总管结石患者82例(治疗组),同期选择40例同种疾病患者采用开腹手术治疗(对照组)。统计一次手术成功率、住院天数、术后并发症。结果治疗组一次手术成功率达95.1%、手术时间为58.7±3.5 min、住院天数为9±4.8 d、术后6例出现并发症,术后4例出现结石残留;对照组一次手术成功率达72.5%、手术时间为112.1±20.1 min、住院天数为14.8±5.7 d、术后8例出现并发症,术后11例出现结石残留。结论应用ERCP技术治疗胆总管结石损伤小、治疗彻底、术后并发症少,临床效果满意。

Objective Summarize and analyze the curative effect evaluation of endoscopic retrograde cholangiopancreatography（ ERCP） combined with endoscopic sphincterotomy（ EST）,and open operation treatment of common bile duct calculi. Methods 82 patients were collected with common bile duct calculi which give the treatment of ERCP and EST as treatment group,40 patients with Common bile duct calculi which give the treatment of open operation as control group。The success rate of the first surgery,hospital stays,postoperative complications were calculated. Results The success rate of the first surgery reached 95. 1% in the treatment group,the operative time was（ 58. 7 ± 3. 5） mins,hospital stays was（ 9 ± 4. 8） days,6 cases with postoperative complications,4 cases with calculi residual after operation。Versus the success rate of the first surgery reached 72. 5% with control group,the operative time was（ 112. 1 ± 20. 1） mins,hospital stays was（ 14. 8 ± 5. 7） days,8 cases with postoperative complications,11 cases with calculi residual after operation. Conclusions ERCP technical as the treatment of common bile duct calculi can lessen damage,complete cure,less complications,and clinical results are satisfactory.