摘要
目的 探讨经十二指肠镜括约肌切开术(EST)后选择腹腔镜胆囊切除术(LC)的手术时机.方法 胆囊结石合并胆总管结石患者240例按随机数字表法分为三组,均行EST联合LC,每组80例,分别于EST术后3d(A组),7d(B组),30d(C组)行LC,并对比各组术中和术后相关临床资料情况.结果 B组LC手术时间(52.5±6.4) min,明显较A组(35.8±5.7) min、C组(34.6±2.6) min延长,差异有统计学意义(P<0.01);B组中转开腹率10.0%(8/80),较A组1.3%(1/80)、C组1.3%(1/80)明显增高,差异有统计学意义(P<0.05);B组术中出血量(51.7土4.8)ml,较A组(27.9±6.4) ml、C组(28.2±3.6) ml明显增多,差异有统计学意义(P<0.01).C组的住院总费用(15 361.2±1007.8)元,较A组(10 085.1±695.4)元、B组(10632.4±855.9)元明显增加,差异有统计学意义(P<0.01).结论 EST术后3d行LC可降低手术难度与中转开腹率,缩短手术时间,手术安全有效,优势明显.
Objective To investigate the operation timing of laparoscopic cholecystectomy (LC)after endoscopic sphincterotomy (EST).Methods A total of 240 patients with cholecystolithiasis and choledocholithiasis received EST combined with LC.They were divided into 3 groups by random digits table method with 80 cases each:3 days after EST(group A),7 days after EST(group B),and 30 days after EST (group C).Intraoperative and postoperative clinical data were compared among three groups.Results The operation time of LC in group B [(52.5 ± 6.4) min] was longer than that in group A and group C [(35.8 ± 5.7),(34.6 ± 2.6) min],and there was significant difference (P < 0.01).The intraoperative conversion rate in group B [10.0 % (8/80)] was higher than that in group A and group C [1.3 % (1/80),1.3 % (1/80)],and there was significant difference (P < 0.05).The amount of bleeding in group B [(51.7 ± 4.8) ml] was larger than that in group A and group C [(27.9 ± 6.4),(28.2 ± 3.6) ml],and there was significant difference (P < 0.01).The cost of hospitalization in group C [(15 361.2 ± 1 007.8) yuan] was more than that in group A and group B [(10 085.1 ± 695.4),(10 632.4 ± 855.9) yuan],and there was significant difference (P< 0.01).Conclusion LC performed 3 days after EST can reduce the operation difficulty and conversion rate,and shorten the operation time,and this modality is safe and effective.
出处
《中国医师进修杂志》
2014年第36期14-16,共3页
Chinese Journal of Postgraduates of Medicine