十二指肠镜与腹腔镜联合应用治疗胆道结石

Laparoscopic and Endoscopic Treatment for Cholelithiasis

目的 评价内镜括约肌切开术(endoscopic sphincterotomy,EST)与腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)治疗胆囊结石合并胆总管结石的效果。方法 49例经内镜逆行胰胆管造影(endoscopic retro-grade cholangiopancreatography,ERCP)、B超证实胆囊结石合并胆总管结石的患者,先行EST及取石术,分别于术后即刻、1d、3d和7d作LC。结果 EST成功率91.84％(45/49);EST联合LC成功率95.56％(43/45)。术后平均住院日6.87d(2～13d)。结论 EST术后即刻与1d行LC治疗胆囊结石合并胆总管结石是安全有效的方法。

Objective To evaluate the efficacy of EST ( endoscopic sphincterotomy ) and LC (laparoscopic cholecystectomy) for gallbladder and CBD stones. Methods Forty nine patients with gallbladder and CBD stones confirmed by ERCP and B - scan were operated . They were performed with LC immediately 1,3,7d after EST and extraction of stones. Results The successful rate of EST was 91.84% (45/49) and that of EST combined with LC was 95. 56% (43/45) . The average in hospitalistry after operation was 6.87 d(2-13d). Conclusion LC immediately after EST is a safe and effective treatment for gallbladder and CBD stones.