LCBDE与ERCP/EST治疗复发性胆总管结石疗效对比

Comparison of the efficacy of LCBDE and ERCP/EST in the treatment of recurrent choledocholithiasis

目的比较LCBDE和ERCP/EST在治疗复发性胆总管结石方面的疗效。方法回顾性分析自2015年1月至2020年1月在我院就诊的复发性胆总管结石患者105例,其中LCBDE组59例,ERCP/EST组46例,比较两组手术时间、住院时间、住院费用、术后并发症发生率及残石发生率等。结果两组在住院时间、出血、胆瘘、术后残石发生率比较,差异无统计学意义(P>0.05)。LCBDE组的平均手术时间为(103.33±21.22)min,明显长于ERCP/EST组的(62.52±13.91)min,差异有统计学意义(P<0.05)。LCBDE组住院费用为(2.41±0.51)万元,明显低于ERCP/EST组的(3.09±0.35)万元,差异有统计学意义(P<0.05)。LCBDE组感染率高于ERCP/EST组,差异有统计学意义(P<0.05),但LCBDE组急性胰腺炎发生率低于ERCP/EST组,差异有统计学意义(P<0.05)。结论LCBDE与ERCP/EST均是治疗复发性胆总管结石的有效方法,术者可根据患者病情选择合理的治疗方案。

Objective To compare the efficacy of LCBDE and ERCP/EST in the treatment of recurrent choledocholithiasis.Methods A total of 105 recurrent choledocholithiasis patients,including 59 patients in the LCBDE group and 46 patients in the ERCP/EST group,admitted to our hospital from January 2015 to January 2020 were retrospectively analyzed.The operation times,hospital stays,hospitalization costs,postoperative complications,incidences of residual stones in the two groups were compared.Results There were no statistically significant differences between the two groups in terms of hospital stay,the incidence of bleeding,biliary fistula,and residual stones(P>0.05).The average operation time in the LCBDE group was(103.33±21.22)minutes,which was higher than that of(62.52±13.91)minutes in the ERCP/EST group,with significant difference(P<0.05).The hospitalization cost in the LCBDE group was(2.41±0.51)ten thousand yuan,which was lower than that of(3.09±0.35)ten thousand yuan in the ERCP/EST group,with significant difference(P<0.05).The infectious rate in the LCBDE group was higher than that in the ERCP/EST group,with significant difference(P<0.05).But the incidence of pancreatitis was lower than that in the ERCP/EST group,with significant difference(P<0.05).Conclusion Both LCBDE and ERCP/EST are effective methods for the treatment of recurrent choledocholithiasis.The surgeon can choose a reasonable treatment plan according to the patient′s condition.