一步法和分步法治疗胆囊结石合并胆总管结石患者疗效及并发症分析

目的 探讨一步法与分步法手术治疗胆囊结石合并胆总管结石患者的疗效.方法 2016年1月～2019年6月我院诊治的胆囊结石合并胆总管结石患者152例,其中87例接受一步法手术,即行腹腔镜胆囊切除(LC)和胆总管探查取石(LCBDE)术,65例接受分步法手术,即行内镜逆行胰胆管造影/乳头括约肌切开(ERCP/EST)和LC...

Efficacy of one-step and step-by-steplaparoscopic cholecystectomy in the treatment of patients with gallbladder stones and common bile duct stones

Objective The aim of this study was to investigate the efficacy of one-step and step-by-step laparoscopic cholecystectomy(LC)in the treatment of patients with gallbladder stones and common bile duct stones.Methods 152 patients with gallbladder stones and common bile duct stones were admitted to our hospital between January 2016 and June 2019,87 patients received one-step surgery,e.g.,LC and laparoscopic common bile duct exploration(LCBDE),and 65 patients received step-by-step surgery,e.g.,endoscopic retrograde cholangiopancreatography/papillary endoscopic sphincterotomy(ERCP/EST)and afterward LC.Results The total surgical time and postoperative catheter placement rate in patients with one-step surgery were(156.3±42.6)min and 98.9%,significantly longer or higher than[(124.4±31.4)min and 15.4%,P<0.05]in patients receiving step-by-step surgery,while the hospital stay and hospitalization cost were(14.4±3.9)d and(27.9±7.0)thousand yuan,significantly shorter or lower than(18.7±4.2)d and(31.24±5.8)thousand yuan(P<0.05)in the latter;there were no statistically significant differences in the surgical success rate and stone clearance rate between the two groups(95.4%vs.93.1%and 100.0%vs.96.9%,respectively,P>0.05);the incidence rate of reflux cholangitis in one-step-treated patients was significantly lower than step-by-step surgery-treated patients(0.0%vss 7.7%,P<0.05),while there was no significant difference in the total incidence of complications between the two groups(19.5%vs.32.1%,P>0.05).Conclusion Both the one-step and step-by-step with patients with gallbladder surgery are efficacious in dealing stones and common bile duct stones,and under some circumstances,the one-step surgery might eradicate the stones rapidly and get a good efficacy.