两种手术方案在老年胆囊结石并发胆总管结石的疗效对比

Efficacy of Two Surgical Schemes in the Treatment of Older Patients with Gallbladder Stones Complicated with Choledocholithiasis

目的比较两种手术方案在老年胆囊结石并发胆总管结石的疗效。方法选取2015年1月~2017年1月唐山市人民医院收治的胆囊结石并发胆总管结石患者146例,根据手术方法分为行胆总管探查取石术联合腹腔镜胆囊切除术(LCBDE+LC)组70例,行十二指肠乳头切开联合腹腔镜胆囊切除术(EST+LC)组76例。比较两组手术及术后临床指标。结果与LCBDE+LC组相比,EST+LC组手术时间明显缩短、术后并发症(术后疼痛、切口感染、胆瘘出血)发生率明显减少、术后不良反应发生率明显减少,差异均具有统计学意义(P<0.05)。结论EST+LC治疗老年胆囊结石并发胆总管结石的手术时间短、创伤小、并发症少、安全有效,值得在临床推广。

Objective To compare the effects of two surgical schemes on gallbladder stones complicated with common bile duct stones in older patients.Methods 146 patients with gallbladder stones complicated with common bile duct stones were selected in Tangshan People's Hospital from January 2015 to January 2017.The patients were divided into LCBDE+LC group and EST+LC group according to surgical methods.In LCBDE+LC group,70 patients underwent laparoscopic common bile duct exploration(LCBDE)combined with laparoscopic cholecystectomy(LC).In EST+LC group,76 patients underwent duodenal endoscopic sphincterotomy(EST)combined with LC.The intraoperative and postoperative clinical indicators in the two groups were documented.Results Compared with LCBDE+LC group,the operation time was shortened,the incidences of postoperative complications and adverse reactions were reduced in EST+LC group,there were significant differences between the two groups(P<0.05).Conclusion EST+LC possesses shorter operation time,less trauma,fewer complications,safety and effectiveness in the treatment of gallbladder stones complicated with choledocholithiasis in older patients.