不同内镜下治疗急性结石性胆管炎的疗效比较

目的:比较急性结石性胆管炎经腹腔镜辅助的电子胆道镜探查取石术与经内镜十二指肠乳头扩张或切开取石术的临床效果。方法:回顾分析2008年10月—2013年9月急性结石性胆管炎103例患者的临床资料,分为经腹腔镜辅助的电子胆道镜探查组(L组,n=64)与经内镜逆行性胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)十二指肠乳头扩张或切开取石治疗组(E组,n=39),比较两组患者的住院时间、住院费用、结石残留率、并发症发生率及结石复发率。结果:L组与E组手术成功率分别为96.25%和89.74%,住院时间分别为(9.6±0.9)d和(8.3±0.7)d,差异均无统计学意义(P0.05)。L组住院费用、结石残留率、并发症的发生率以及结石复发率均明显低于E组,差异均有统计学意义(P0.05)。结论:对急性结石性胆管炎患者的治疗,经腹腔镜辅助的电子胆道镜胆道探查术及经ERCP十二指肠乳头扩张或切开取石后再行LC术均可行,但前者更具临床优越性。

Comparison of Clinical Efficacy of Different Endoscopic Approaches on Treatment of Acute Cholangitis with Bile Duct Stones

Objective：To compare the clinical efficacy of laparoscopy-assisted choledochoelectroscopy and endoscopic retrograde cholangiopancreatography on treatment of acute cholangitis with bile duct stones. Methods：The clinical datum of 103 cases of a- cute cholangitis with bile duct stones treated by laparoscopy-assisted choledochoelectroscopy （Group L, n = 64） or endoscopic retrograde cholangiopancreatography （Group E, n = 39） from October 2008 to September 2013 were analyzed retrospectively. In hospital days, costs, the rates of residual stones, the rates of complications and the stone recurrence rates were compared between the two groups. Results： The operation success rates were 96.25% and 89. 74%, and hospital days were （9.6 ± 0.9） and （8.3 ±0.7） days in Group L and Group E, respectively, but had no stastically significant differences （P〉0.05）. The cost, the rate of residual stones, the rates of complications and the stone recurrence rate in Group L were significantly lower than those in Group E （P〈0.05）. Conclusions： Acute cholangitis with bile duct stones can be treated by laparoscopy-assisted choledochoelectroscopy or endoscopic retrograde cholangiopancreatography. However, the former presents more clinical advan- tages.