ERCP和EST在腹腔镜胆囊切除术中的作用

Application of endoscopic retrograde cholangiopancreatography and end oscopic sphincterotomy in laparoscopic cholecystectomy

目的 总结腹腔镜胆囊切除术 (Laparoscopiccholecystectomy ,LC)中联合应用内镜技术治疗伴有胆总管结石的胆囊结石病人的疗效。 方法 对 2 10例 (同济医院 12 4例 ,武汉市第四医院 86例 )LC术前、术后可疑合并胆总管结石行内镜逆行胰胆管造影术 (Endoscopicretrogradecholangiopancreatogrophy ,ERCP)和内镜括约肌切开术 (Endoscopicsphincterotomy ,EST)。 结果 LC术前ERCP发现胆总管结石 69例 ,EST清除 63例 ,清除率 91 3 % ( 63 69) ;LC术后ERCP发现胆总管残留结石 9例 ,EST清除 8例 ,清除率 88 9% ( 8 9)。 结论 LC联合ERCP、EST治疗胆囊结石合并胆总管结石是一种安全有效的方法 。

ObjectiveTo summarize the curative effect of l aparoscopic cholecys tectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) for cholelithiasis concurrent with choledoc holithiasis.MethodsERCP and EST were applied in 210 patients suspected for c holedocholithiasis before (164 cases) or after (46 cases)LC.Results ERCP dis closed choledocholithiasis in 69 patients before LC, and then stones were comple tely removed by EST in 63 patients, with a clearance rate of 91 3% (63/69); ERC P revealed residual cholelith in 9 patients after LC, and 8 of them were cured by EST, with a clearance rate of 88 9% (8/9).ConclusionsLC co mbined with ERCP and EST for cholelithiasis concurrent with choledocholithiasis is safe and effec tive, keeping patients free from open surgery.