两种微创手术治疗老年患者胆囊结石合并胆总管结石的临床对比研究

【摘要】〓目的〓比较腹腔镜胆囊切除+胆总管探查(LC+LCBDE)与内镜逆行胰胆管造影/内镜下0ddi括约肌切开术(ERCP/EST)联合腹腔镜胆囊切除术(LC)治疗老年患者胆囊结石合并胆总管结石的临床效果。方法〓回顾性分析我院肝胆外科2010年1月到2013年1月收治的96例老年患者胆囊结石合并胆总管结石的临床资料,其中38例行LC+LCBDE,58例行EST+LC,对两组患者手术成功率、结石清除率、总的并发症发生率、住院时间、住院费用等进行比较分析。结果〓两组患者并发症发生率、结石清除率及手术成功率差距均无统计学意义(P>0.05),LC+LCBDE组住院时间及费用明显低于ERCP/EST+LC组。结论〓对于老年胆囊结石合并胆总管结石患者,两种手术方式都是安全有效的。对于符合条件的老年患者,LC+LCBDE可作为主要的治疗方式。

Comparison of two kinds of minimally invasive operation in treating concomitant cholecystolithiasis and choledocholithiasis in senile patients

Objective To evaluate the therapeutic effect of laparoscopic cholecystectomy （LC） ＋laparoscopic common bile duct exploration（LCBDE） and endoscopic retrograde cholangiopancreatography （ERCP）/endoscopic sphincterotomy （EST）＋LC in treatment for concomitant cholecystolithiasis and choledocholithiasis in senile patients. Methods The clinical data of 96 senile patients with cholecystolithiasis and choledocholithiasis, who underwent surgical treatment in our hospital from January 2010 to January 2013 were retrospectively analyzed. Thirty-eight senile patients received LC＋LCBDE, and the others underwent ERCP/EST＋LC. The success rate of operation, the clearance rate of calculus, incidence of postoperative complications, hospital stay, and hospitalization charge were compared between two groups. Results There were no statistical significances in the success rate of operation, the clearance rate of calculus, and incidence of postoperative complications between two groups （P〉0.05）. Hospital charge and time of hospital stay were lower in LC＋LCBDE group. Conclusion Both LC ＋ LCBDE and LC ＋ERCP/EST are safe and effective for senile patients with cholecystolithiasis and choledocholithiasis. The LC＋LCBDE is a primary choice for the appropriate cases.