乳头括约肌切开术联合腹腔镜胆囊切除术治疗胆囊并胆管结石的临床观察

[目的]探讨乳头括约肌切开术（EST）联合腹腔镜胆囊切除术（LC）治疗胆囊及胆总管结石的应用价值。[方法1226例胆囊结石合并胆管结石患者随机分为观察组和对照组，观察组行EST联用LC，对照组行开腹胆管探查T管引流。观察两组治疗后并发症、住院时间、恢复情况等。[结果]观察组住院时间及排气时间短，术后镇痛次数少，与对照组比较有显著性差异（P〈0．05）。观察组并发症发生率为7．89％，与对照组（7．14％）比较差异无统计学意义（P〉0．05）。[结论]EST联合LC利用内镜、腹腔镜的优势，充分体现微创治疗的特点，优于传统开腹手术。

Clinical Observation on EST Combined with LC in the Treatment of Gailbladder Stones with Common Bile Duct Stones

[Objective] To investigate the value of endoscopic sphincterotomy （EST） combined with lapa- roscopic cholecystectomy （LC） in the treatment of gallbladder stones and common bile duct stones. [Methods] A total of 226 cases of patients were randomly divided into observation group and control group. The patients in the observation group were treated with EST combined with LC, and the patients in the control group were treated with open T-tube drainage of bile duct exploration. After treatment, the complications, hospital stay and recovery in two groups were observed. [Results] In the observation group, the hospitalization time and exhaust time were shorter and the number of analgesic was less than those in the control group （ P 〈0.05）. The incidence rate of the complication of the observation group was 7.89 %, and that of the control group was 7.14%, and there was no significant difference between two groups （ P 〈0.05）. [Conclusion]EST combined with LC has the advantages of digestive endoscope and laparoscopy, and presents characteristics of mini-invasire surgery. It is superior to open choledocholithotomy.