不同微创治疗方案在老年胆囊结石合并胆总管结石中的疗效

Efficacy of different minimally invasive treatment schemes in elderly patients with cholecystolithiasis and common bile duct stones

目的评价不同微创治疗方案在老年胆囊结石合并胆总管结石中的疗效。方法选取我院2016年4月至2018年1月收治的老年胆囊结石合并胆总管结石患者100例,将所有患者按随机数字法分为观察组(50例)和对照组(50例)。观察组接受腹腔镜胆囊切除术(LC)联合胆总管探查取石术(LCBDE)治疗,对照组接受LC联合内镜逆行胰胆管造影(ERCP)/内镜十二指肠乳头括约肌切开术(EST)治疗。比较两组治疗效果。结果观察组患者的住院时间短于对照组,住院费用低于对照组(P<0.05);两组患者的手术成功率、结石残留率及并发症发生率比较,差异无统计学意义(P>0.05)。两组随访结果无明显差异(P>0.05)。结论两种微创术式治疗胆囊结石合并胆总管结石均具有理想的临床效果与较高的安全性,其中LC+LCBDE治疗成本较低,可根据患者自身情况选择合适的手术治疗方案。

Objective To evaluate the efficacy of different minimally invasive treatment schemes in elderly patients with cholecystolithiasis and common bile duct stones. Methods A total of 100 cases elderly patients with cholecystolithiasis and common bile duct stones treated in our hospital from April 2016 to January 2018 were selected. All the patients were divided into observation group(50 cases) and control group(50 cases) according to random number method. The observation group received laparoscopic cholecystectomy(LC) combined with laparoscopic common bile duct exploration(LCBDE), and the control group received LC combined with endoscopic retrograde cholangiopancreatography(ERCP)/endoscopic sphincterotomy(EST). The treatment effects of the two groups were compared. Results The hospitalization time in the observation group was shorter than that in the control group, and hospitalization expense was lower than that in the control group(P <0.05). There were no significant differences in the success rate of surgery, stone residual rate and incidence of complication between the two groups(P>0.05). There was no significant difference in the follow-up results between the two groups(P>0.05). Conclusion Two kinds of minimally invasive surgery have ideal clinical efficacy and high safety in the treatment of cholecystolithiasis and common bile duct stones. The LC+LCBDE has low treatment cost. Suitable surgical treatment can be selected according to the patients’ own condition.