腹腔镜胆总管探查术或内镜逆行胰胆管造影联合腹腔镜胆囊切除术治疗胆囊结石合并胆总管结石的效果比较

Effect comparison of laparoscopic common bile duct exploration or endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy for cholecystolithiasis and choledocholithiasis

目的比较腹腔镜胆总管探查术(LCBDE)或内镜逆行胰胆管造影(ERCP)联合腹腔镜胆囊切除术(LC)治疗胆囊结石合并胆总管结石的临床价值。方法选取本院90例胆囊结石合并胆总管结石患者,按随机数表法将其分为LCBDE+LC组与ERCP+LC组,各45例,并分别实施相应手术。比较两组手术指标、术后并发症发生情况及术后随访情况。结果 LCBDE+LC组术后住院时间短于ERCP+LC组,手术费用及术后并发症总发生率低于ERCP+LC组(P<0.05)。两组的结石残留率、术后1年结石复发率比较,差异不显著(P>0.05)。结论 LCBDE+LC与ERCP+LC治疗胆囊结石合并胆总管结石均可有效清除结石,且复发风险低,但LCBDE+LC的术后并发症少,术后恢复快,并可减轻患者经济负担。

Objective To compare the clinical value of laparoscopic common bile duct exploration (LCBDE) or endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) in the treatment of cholecystolithiasis and choledocholithiasis.Methods Ninety patients with cholecystolithiasis and choledocholithiasis in our hospital were divided into LCBDE+LC group and ERCP+LC group according to the random number table method, with 45 cases in each group, and the corresponding operations were performed respectively.The operative indexes, postoperative complications and postoperative follow-up were compared between the two groups.Results The postoperative hospitalization time of the LCBDE+LC group was shorter than that of the ERCP+LC group, and operation cost and total incidence of postoperative complications were lower than those of the ERCP+LC group (P<0.05).There were no significant differences in residual stone rate and recurrence rate of stones at postoperative one year between the two groups (P>0.05).Conclusion LCBDE+LC and ERCP+LC can effectively remove stones in the treatment of cholecystolithiasis and choledocholithiasis, and the risk of recurrence is low.But LCBDE+LC has fewer complications and fast postoperative recovery of the patients and can reduce the economic burden of the patients.