腹腔镜胆总管探查+胆囊切除术与内镜逆行性胰导管造影+胆囊切除术的预后效果比较

Comparison of the prognostic effects of laparoscopic common bile duct exploration and cholecystectomy with endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy

目的:探讨两种手术方式治疗胆囊结石合并胆总管结石的预后。方法:回顾分析2016~2019年收治的胆囊结石合并胆总管结石患者的临床资料,分别行腹腔镜胆总管探查+胆囊切除术(A组)与内镜逆行胰胆管造影+腹腔镜胆囊切除术(B组),对比两组预后相关指标、并发症等。结果:两组术后住院时间、术后带管时间、并发症差异无统计学意义(P>0.05);A组总住院时间少于B组,总出血量多于B组,差异有统计学意义(P<0.05)。结论:腹腔镜胆总管探查+胆囊切除术治疗胆总管结石合并胆囊结石住院时间较短,疗效较好;内镜逆行胰胆管造影+腹腔镜胆囊切除术出血量少,创伤较小,尽管适用条件相对受限,但也是良好的治疗方案之一。应根据实际情况选择临床治疗方案。

Objective:To investigate the prognosis of two different surgical methods for cholecystolithiasis complicated with choledocholithiasis.Methods:The clinical data of patients who suffered from cholecystolithiasis complicated with choledocholithiasis from 2016 to 2019 were analyzed retrospectively.They underwent laparoscopic common bile duct exploration+laparoscopic cholecystectomy(group A,20 cases)and endoscopic retrograde cholangiopancreatography+laparoscopic cholecystectomy(group B,20 cases),and the prognostic indicators and complications of the two groups were compared.Results:There was no significant difference between group A and group B in postoperative hospital stay,postoperative catheter insertion time and complications(P>0.05).The total hospital stay in group A was less than that in group B,the total blood loss in group A was higher than that in group B,the difference was statistically significant(P<0.05).Conclusions:Laparoscopic common bile duct exploration and laparoscopic cholecystectomy has advantages of short hospital stay and good therapeutic effect in the treatment of common bile duct stones and gallbladder stones.Endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy has less blood loss and fewer trauma,and has become one of the best therapeutic schemes despite the relatively limited applicable conditions.The treatment method should be selected according to the actual situation.