腹腔镜联合ERCP治疗胆囊结石伴胆总管结石52例临床分析

目的探讨逆行胰胆管造影术(ERCP)联合腹腔镜胆囊切除术(LC)对胆囊结石伴胆总管结石治疗的临床应用。方法 52例胆囊结石伴胆总管结石病变患者,先用ERCP、乳头切开术(EST)取石;或ERCP和鼻胆管引流(ENBD)及柱状气囊扩张术(EPBD)治疗,术后6~10天,患者无发热、腹痛,血淀粉酶正常,再按常规四孔法施行LC。结果 52例成功完成ERCP术。52例胆总管结石全部取尽并完成LC术。2例(3.8%)ERCP术后急性轻型胰腺炎,无LC和EST相关并发症。结论 ERCP联合腹腔镜对胆囊结石伴胆管病变的治疗,符合外科微创诊治理念,是外科微创术式的可靠选择。

The clinical application of laparoscopic cholecystectomy combined the ERCP procedure with for treatment of the cholecystic stone concomitant with choledocholithiasis

Objective Retrograde cholangiopancreatography（ERCP） combined laparoscopic cholecystectomy（LC） for gallbladderstones treated with the clinical application of common bile duct stones. Methods 52 patients with biliary tract disease in patients with gallbladder stones,first with ERCP,after 6 to 10 days,the patient no fever,abdominal pain,serum amylase normal,then conventional four-port LC. Results All patients successful completed the ERCP surgery and LC. 2 of 52 cases（3. 8%） had got post ERCP pancreatitis. There was no complication in LC procedure. Conclusion ERCP with gallbladder stone Laparoscopic treatment of bile duct lesions,in line with minimally invasive surgical treatment concept is a reliable surgical minimally invasive surgical option.