LCBDE联合LC与ERCP/EST联合LC治疗胆总管结石合并胆囊结石的疗效对比

Comparison of efficacy of LCBDE combined with LC and ERCP/EST combined with LC in the treatment of choledocholithiasis combined with cholecystolithiasis

目的:比较用腹腔镜下胆总管探查取石术(LCBDE)联合腹腔镜胆囊切除术(LC)与内镜下逆行胰胆管造影/内镜下括约肌切开取石术(ERCP/EST)联合LC治疗胆总管结石合并胆囊结石的疗效。方法:选择彭州市中西医结合医院2016年12月至2018年12月期间接诊的58例胆总管结石合并胆囊结石患者作为研究对象。采用随机数表法将其均分为参考组和研究组(29例/组)。对研究组患者进行LCBDE+LC,对参考组患者进行ERCP/EST+LC。然后对比两组患者的临床疗效。结果:1)两组患者术中的出血量和术后的VAS评分相比,差异无统计学意义(P>0.05)。研究组患者手术的时间和住院的时间均短于参考组患者,差异有统计学意义(P<0.05)。2)研究组患者术后并发症的发生率低于参考组患者,差异有统计学意义(P<0.05)。3)两组患者结石的清除率相比,差异无统计学意义(P>0.05)。结论:用ERCP/EST+LC与LCBDE+LC治疗胆总管结石合并胆囊结石均可取得较好的效果。与采用ERCP/EST+LC相比,用LCBDE+LC治疗胆总管结石合并胆囊结石可显著缩短患者手术的时间和住院的时间,降低其术后并发症的发生率。

objective:to compare the efficacy of laparoscopic choledocholithotomy(LCBDE)combined with laparoscopic cholecystectomy(LC)and ERCP/EST combined with LC in the treatment of choledocholithiasis combined with cholecystolithiasis.Methods:a total of 58 patients with choledocholithiasis complicated with cholecystolithiasis admitted to pengzhou hospital of integrated traditional Chinese and western medicine from December 2016 to December 2018 were selected as subjects.All of them were divided into reference group and study group(29 cases/group)by random number table method.Patients in the study group were given LCBDE+LC,and patients in the reference group were given ERCP/EST+LC.Then the clinical efficacy of the two groups was compared.Results:1)there was no significant difference in intraoperative blood loss and postoperative VAS score between the two groups(P>0.05).The duration of surgery and hospitalization in the study group was shorter than that in the reference group,with statistically significant differences(P<0.05).2)the incidence of postoperative complications in the study group was lower than that in the reference group,with a statistically significant difference(P<0.05).3)there was no significant difference in stone clearance rate between the two groups(P>0.05).Conclusion:ERCP/EST+LC and LCBDE+LC can be used to treat choledocholithiasis combined with cholecystolithiasis.Compared with ERCP/EST+LC,the treatment of choledocholithiasis complicated with cholecystolithiasis with LCBDE+LC can significantly shorten the time of operation and hospitalization and reduce the incidence of postoperative complications.