腹腔镜胆总管探查术与内镜下十二指肠乳头括约肌切开术治疗胆总管结石的效果

Effect of laparoscopic common bile duct exploration and endoscopic sphincterotomy of duodenal papilla in the treatment of common bile duct stones

目的探讨胆总管结石采用腹腔镜胆总管探查术(LCBDE)与内镜下十二指肠乳头括约肌切开术(EST)治疗的疗效。方法选取2014年5月—2015年5月期间笔者所在医院接收的128例胆总管结石患者,随机分为EST-LC组和胆总管探查术(LCBDE)组,组内均有64例,观察两组疗效。结果 EST-LC组手术成功率、结石残留率、复发率、并发症发生率与LCBDE组相比无显著性差异(P>0.05);在结石数量、胆总管内径方面,LCBDE组相较于EST-LC组更多、更大(P<0.05);LCBDE组住院时间、住院费用均显著低于EST-LC组(P<0.05)。结论LCBDE组与EST-LC组相比,二者手术成功率均较高,创伤小,术后并发症发生率均较低,而前者避免EST-LC两次分期手术对患者的创伤,故值得推广应用。

Objective To investigate the therapeutic effect of laparoscopic common bile duct exploration （LCBDE） and endoscopic sphincterotomy of duodenal papilla （EST） in the treatment of common bile duct stones. Methods The 128 cases of common bile duct stones were selected from May 2014 to May 2015 in author＇s hospital,and were randomly divided into EST-LC group and common bile duct exploratio（LCBDE） group,64 cases for each. Two groups＂ curative effect were observed. Results There was no significant difference in the success rate,residual stone rate,recurrence rate,complication in cidenee rate of EST-LC group compared with LCBDE group（P〉0.05）;In terms of the number of stones,bile duct diameter,LCBDE group were more than EST-LC group （P〈0.05）;length of stay,medical costs in LCBDE group were significantly lower than the EST-LC group （P〈0.05）. Conclusion Compared LCBD with EST-LC,two groups had higher success rate,less trauma,less postoperative complication incidence rate,and the former is worth to be popularized and applied to avoid the trauma of EST-LC at secondary staging operation.