LCBDE+LC与ERCP+LC治疗胆总管结石伴胆囊结石的疗效对比

Comparison of LCBDE+LC and ERCP+LC in the treatment of common bile duct stones with gallstones

目的对比腹腔镜胆总管切开胆道镜探查取石术(LCBDE)联合腹腔镜胆囊切除术(LC)与内镜逆行胰胆管造影术(ERCP)联合LC两种术式在胆总管结石伴胆囊结石治疗中的疗效差异,并分析术式优越性。方法前瞻性分析我院肝胆外科2012年1月至2015年1月156例胆总管结石伴胆囊结石患者临床资料,随机分为LC+LCBDE组与ERCP+LC组各78例。对比两组术后并发症及生活质量指数(GIQLI)等。结果 LC+LCBDE组与ERCP+LC组手术一般情况差异无统计学意义(P>0.05);LC+LCBDE组残石率,胰腺炎、胆管炎发生率均低于ERCP+LC组(P<0.05);LC+LCBDE组术后GIQLI生存质量优于ERCP+LC组(P<0.05)。结论 LC+LCBDE术式具有创伤小、并发症低、术后生存质量高等优点,可作为首选术式。

Objective To compare the curative effects of laparoscopic common bile duct exploration(LCBDE)combined with laparoscopic cholecystectomy(LC)and endoscopic retrograde cholangiopancreatography/endoscopicsphincterotomy(ERCP)combined with LC on cholecystolithiasis and choledocholithiasis.Methods A total of156patients with cholecystolithiasis and choledocholithiasis who were admitted to the Department of Biliary and Pancreatic Surgery of our hospital between January2012and January2015were prospectively analyzed.Patients were divided into LC+LCBDE group(n=78)and ERCP+LC group(n=78)according to random number table.The operation complications and quality of life questionnaire between two groups were compared.Results The clinical information showed no statistically significant difference between LC+LCBDE group and ERCP+LC group(P>0.05).The incidence rates of residual stones,pancreatitis,cholangitis in LC+LCBDE group were lower than those in ERCP+LC group(P<0.05).In addition,postoperative Gastrointestinal Qualityof Life Index(GIQLI)in LC+LCBDE group were higher than those in ERCP+LC group(P<0.05).Conclusions LC+LCBDE has less minimal invasive,lower complications,less cost,better patients compliance and higher postoperative survival quality,which may be used as the first choice.