ERCP／EST术后LC治疗老年胆囊结石伴胆总管结石的临床分析

Clinical analysis of laparoscopic cholecystectomy for treatment of elderly patients with cholecystolithiasis and choledocholithiasis after ERCP/EST

目的探讨经内镜逆行胰胆管造影（ERCP）／乳头括约肌切开术（EST）后行腹腔镜胆囊切除术（LC）治疗老年胆囊结石合并胆总管结石的疗效。方法回顾性分析我院采用ERCP／EST术后LC序贯治疗的56例老年胆囊结石伴胆总管结石患者的临床资料。结果56例患者中53例（94．6％）顺利行ERCP／EST取石后行LC，术后一过性高淀粉酶血症患者8例，其中2例并发急性轻型胰腺炎，予以保守治疗后好转。3例患者中转开腹手术（5．7％），无严重并发症发生。结论采用ERCP／EST后LC序贯治疗老年胆囊结石伴胆总管结石不失为一种安全、有效、可行的手术方式。

Objective To investigate the efficacy of laparoscopic cholecystectomy （LC） in the treatment of elderly patients with cholecystolithiasis and choledocholithiasis after endoscopic retrograde cholangio -pancreatography （ECRP）/ endoscopic sphincterotomy （EST）. Methods A total of 56 elderly patients with cholecystolithiasis and choledocholithia- sis after ERCP/EST followed by LC in our hospital were included into the current study. Their clinical data were collected for retrospective analysis. Results ERCP/EST followed by LC was successfully carried out in 53 patients （94.6%）. After surgery, there were 8 patients reporting hyperamylasemia, including 2 patients with acute light pancreatitis, who were recovered after conservative therapy. Also, 3 patients were converted to open surgery （5.7%）. No serious compli- cations occurred. Conclusions ERCP/EST followed by LC is a safe, effective and feasible surgical approach for elderly patients with cholecystolithiasis and choledocholithiasis.