两种微创方案治疗胆囊结石并胆总管结石的疗效对比

Comparison of the Curative Effect of Two Minimally Invasive Methods In the Treatment of Cholecystolithiasis and Choledocholithiasis

目的比较腹腔镜胆囊切除术(LC)+胆道镜胆总管探查取石术(LCBDE)与LC+内镜下十二指肠乳头括约肌切开取石术(EST)治疗胆囊结石并胆总管结石的临床疗效。方法收集我院2013年1月～2017年12月收治的胆囊结石合并胆总管结石患者104例作为研究对象,按照手术方法分为LC+LCBDE组和LC+EST组,各52例。比较两组患者手术时间、术中出血量、住院时间、并发症发生率以及Oddis括约肌损伤发生率。结果 LC+LCBDE组患者的手术时间(131.52±25.71)min、住院时间(8.13±2.35)d、并发症发生率(15.38%)、Oddis括约肌损伤发生率(3.85%)均低于LC+EST组的(167.12±35.24)min、(10.37±3.25)d、48.07%、25.00%,差异均有统计学意义(P<0.05);两组术中出血量比较,差异无统计学意义(P>0.05)。结论 LC+LCBDE和LC+EST均是治疗胆囊结石并胆总管结石的有效微创手段,LC+LCBDE方案具有手术时间短、住院时间短、并发症发生率低的优点,同时能保护Oddis括约肌的正常功能,具有一定的优越性。

Objective To compare the clinical outcomes of laparoscopic cholecystectomy (LC)+ choledochoscopy with common bile duct exploration (LCBDE) and LC + endoscopic duodenal papillary sphincter incision (EST) for the treatment of gallbladder stones and common bile duct stones. Efficacy.Methods A total of 104 patients with gallstones complicated with common bile duct stones admitted to our hospital from January 2013 to December 2017 were enrolled. The patients were divided into LC+LCBDE group and LC+EST group, 52 cases each. The operation time, intraoperative blood loss, hospitalization time, complication rate and incidence of Oddis sphincter injury were compared between the two groups.Results The operation time (131.52±25.71) min, hospitalization time (8.13±2.35) d, complication rate (15.38%) and Oddis sphincter injury rate (3.85%) were lower in the LC+LCBDE group than in the LC+EST group(167.12±35.24) min,(10.37±3.25)d, 48.07%, 25.00%, the difference was statistically significant (P<0.05). There was no significant difference in the amount of intraoperative blood loss between the two groups (P>0.05).Conclusion LC+LCBDE and LC+EST are effective minimally invasive methods for the treatment of gallstones and common bile duct stones. LC+LCBDE has the advantages of short operation time, short hospital stay and low complication rate, and can protect Oddis sphincter. Normal function has certain advantages.