腹腔镜联合十二指肠镜同期治疗胆囊结石合并肝外型肝胆管结石疗效观察

Efficacy observation of laparoscopy combined with intraoperative endoscopic retrograde cholangio-pancreatography for treatment of cholelithiasis and concomitant choledocholithiasis

目的探讨腹腔镜胆囊切除术与术中经十二指肠镜逆行胆胰管造影同期治疗胆囊结石合并肝外型胆总管结石的临床疗效。方法回顾性分析我院收治的胆囊结石合并肝外型胆总管结石患者111例,根据术式不同分为观察组(LC+IO-ERCP)和对照组(pre-ERCP+LC)。比较两组患者手术相关指标、住院时间、住院费用及术后并发症发生情况。结果对照组4例未同期完成,手术成功率92.86%;观察组均一次完成手术,成功率100.00%。两组结石残留率差异无统计学意义(P>0.05),对照组术后住院天数、总住院时间、住院总费用优于观察组,差异均有统计学意义(P<0.05);对照组术后并发症发生率为10.71%,观察组为7.27%,差异无统计学意义(P>0.05)。结论腹腔镜联合十二指肠镜同期治疗胆囊结石并肝外型肝胆管结石安全有效,且恢复快、费用低。

Objective To investigate the clinical efficacy of laparoscopic cholecystectomy （LC） combined with intraoperative endoscopic retrograde cholangio-pancreatography （IO-ERCP） for cholelithiasis and concomitant choledocholithiasis. Methods The clinical data of 111 case of patients with cholelithiasis and concomitant choledocholithiasis in our hospital were retrospectively analyzed and divided into observation group（LC＋IO-ERCP） and control group （pre-ERCP＋LC） according to the different surgical methods. The surgery related indicators, hospital stay, hospitalization expenses and postoperative complications of the two groups were compared. Results Four patients of control group did not complete the operation, and the success rate was 92.86%; all patients of observation group completed the operation, and the success rate was 100.00%. The rates of remain calculus between the two groups had no significant difference（P〉0.05）. The hospital stay, hospitalization expenses and hospitalization expenses in observation group were significantly better than that of control group（P〈0.05）. The incidence of complications in control group was 10.7%, while the incidence of complications in observation group was 5.3%, and there was no significant difference （P〉0.05）. Conclusion Laparoscopic cholecystectomy combined with intraoperative endoscopic retrograde cholangio-pancreatography is safe and effective for treatment of cholelithiasis and concomitant choledocholithiasis. It has an advantages in quicker recovery speed and lower cost.