经内镜及外科手术治疗肝外胆管结石的疗效比较

目的探讨经内镜治疗肝外胆管结石的价值。方法将２００例肝外胆管结石患者分为内镜治疗组（内镜组）及外科手术组（手术组）各１００例，内镜组首先完成经内镜胆胰管造影，诊断确立后即时行十二指肠乳头切开术及胆管取石术；手术组确诊后根据病情选择不同术式，行开腹手术。结果内镜组治愈率为９８％，手术组为９０％（Ｐ＜０．０１）；黄疸消退时间内镜组为（３．０５±０．１２）天，手术组为（７．８３±０．３２）天（Ｐ＜０．０１）；残余结石发生率内镜组为２％，手术组为１０％（Ｐ＜０．０１）；住院时间内镜组为（４．６２±０．１７）天，手术组为（２３．５９±２．７６）天（Ｐ＜０．０１）。结论经内镜治疗肝外胆管结石的疗效明显优于手术疗效，是一种安全可靠的治疗方法。

Comparative efficacy after endoscopic versus surgical intervention for extrahepatic billiary stone

Objective The consequences of interventional endoscopy for extrahepatic biliary stones were summed up and compared with that after traditional surgery. Methods Each 100 cases with extrahepatic biliary stone constituted the group undergoing endoscopic or operative therapy.Once diagnosis had been established by ERCP,endoscopic sphinterotomy(EST) was immediately followed to extract stones.Mode of operation preformed after celiotomy varied with indication. Results Rate of stone extraction reached 98% by EST and 90% by open surgery(P<0.01);days for initial jaundice ebbing and hospitalization were respectively 3.050.12,4.620.17 and 7.830.32,23.592.76;incidence of residual stone occurred in 2% of cases for the former and 10% for the latter(P<0.01). Conclusion The therapeutic efficacy of EST seemed better than open surgery.