腔镜胆总管切开术与内镜联合腹腔镜治疗胆总管结石的临床分析

目的对腹腔镜胆总管切开术与内镜联合腹腔镜治疗胆囊结石合并胆总管结石的疗效进行比较和评价。方法回顾性分析2002年7月至2007年7月，20例行腹腔镜胆囊切除、胆总管探查（LCD组），15例行腹腔镜胆囊切除联合内镜乳头括约肌切开取石术（EST＋LC组）患者的手术及术后情况。结果LCD组近期并发症发生率低于EST＋LC组（20％ vs 5％，P〈0．05），LCD组平均住院日和平均住院费用均明显低于EST＋LC组（P〈0．05），手术成功率两组差异无统计学意义（P〉0．05）。结论腹腔镜胆总管切开术是治疗胆囊结石并胆总管结石疗效肯定的微创手术。

The clinical research of laparoscopic choledochotomy vs endoscopic sphincterotomy combined with laparoscopic cholecystectomy in the treatment of common bile duct stones

Objective To evaluate the therapeutic effect of different laparoscopic treatments for cholecystolithiasis and choledocholithiasis.Methods From July 2002 to July 2007,the data of 20 cases receiving laparoscopic choledochotomy(LCD group) and 15 cases of common duct stones receiving laparoscopic cholecystectomy after endoscopic sphincterotomy(EST LC group) were analyzed retrospectively.Results The complication morbidity in EST LC group was higher significantly,the average hospital stay was longer and cost of hospitalization was less than in LCD group(all P<0.05).There was no significant difference in success rate of the operation(P>0.05).Conclusion The LCD for treating cholecystolithiasis and choledocholithiasis is safe and feasible with a confirmative curative effect and minimal invasion.