胆囊结石合并胆总管结石ERCP术后行LC时间节点的选择

Study on the Operation Timing of LC After ERCP in Patients with Cholecystolithiasis Complicated with Choledocholithiasis

目的明确胆囊结石合并胆总管结石患者内镜逆行胰腺胆管造影(ERCP)术后行腹腔镜胆囊切除术(LC)的最佳时间节点。方法选择我院2012年4月至2017年6月收治的108例胆囊结石合并胆总管结石患者,根据ERCP术后行LC间隔时间将患者分为两组:A组65例:ERCP术后1~3天行LC术;B组43例:ERCP术后7~10天行LC术。比较两组患者的手术效果、并发症发生率、住院时间及住院费用。结果 A组及B组的并发症无显著差异(P>0.05)。A组患者的住院费用和住院时间分别为30 953元和6.2天,显著少于B组的38 864元和12.3天,差异有统计学意义(P<0.05)。结论对于胆囊结石合并胆总管结石患者,ERCP术后尽早行LC术不增加并发症的几率,却可以减少住院时间及费用。

Objective To identify the best timing of laparoscopic cholecystectomy （LC） after endoscopic retrograde cholangiopancre- atography （ERCP） in patients with cholecystolithiasis complicated choledocholithiasis. Methods 108 cases of patients with cholecystolithia- sis complicated with choledocholithiasis admitted to our hospital from April 2012 to June 2017 were selected and divided into two groups accordidg to the LC interval time after ERCP. For 65 patients in group A, LC was performed within 1 to 3 days after ERCP; for 43 patients in group B, LC was performed within 7 to 10 days after ERCP. The surgical effect, incidence of complications, hospitalization time and hospi- talization cost were compared between the two groups. Results No significant difference was found between group A and group B in the complications （P〉0.05）. The hospitalization cost and hospitalization time of the group A was 30 953 Yuan and 6.2 days respectively, signifi- cantly lower than 38 864 Yuan and 12.3 days of the group B （P〈0.05）. Conclusions For patients with cholecystolithiasis complicated with choledocholithiasis, early LC after ERCP does not increase the complication rate, but can reduce the hospitalization time and cost.