“三镜”联合微创治疗胆囊结石并胆总管结石的临床研究

目的：探讨应用＂三镜＂联合治疗胆囊结石并胆道结石的疗效。方法：回顾分析2005年1月至2009年12月治疗101例胆囊结石并胆总管结石患者的临床资料,其中行内镜下乳头括约肌切开术（endoscopic sphincterotomy,EST）＋腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）25例,LC＋腹腔镜胆总管探查术（laparoscopic common bile duct exploration,LCBDE）23例,53例行LC＋EST＋LCBDE,并对比分析3组患者胆总管内径、结石大小、手术时间、治疗费用、并发症发生率、术后住院时间、手术成功率等。结果：＂三镜＂联合与其他两种方法相比,并发症发生率低,手术时间和住院时间亦不延长。结论：＂三镜＂联合是目前治疗胆囊结石并胆总管结石的较好选择,是安全可靠、疗效确切的微创治疗方案,值得推广。

Clinical study of "three endoscopes" in the treatment of cholecystolithiasis complicated with common duct stones

Objective:To discuss the therapeutic effect of three endoscopies for treatment of cholecystolithiasis complicated with common duct stones.Methods:The clinical data of 101 patients who suffered from cholecystolithiasis complicated with common duct stones from Jan.2005 to Dec.2009 were retrospectively analyzed.25 patients were treated with endoscopic sphincterotomy(EST) and laparoscopic cholecystectomy(LC),23 patients with LC and laparoscopic common bile duct exploration(LCBDE),53 patients with LC+EST+LCBDE.The data of 3 groups were compared and analyzed,including common bile duct diameter,stone size,total operation time,surgery expense,complication rate,hospital stay and success rate of surgery.Results:Compared with other two therapies,"three endoscopes" therapy had lower complication rate,similar operative time and hospital stay.Conclusions:"Three endoscopes" therapy is a better choice in treatment of cholecystolithiasis complicated with common duct stone,is a safe,reliable and mini-invasive therapy with definite therapeutic effect.It is worthy of generalization.