两内镜联合治疗胆囊结石并肝外胆管结石

目的探讨胆囊结石并肝外胆管结石的治疗方法。方法回顾分析78例采用十二指肠镜乳头括约肌切开术（EST）或者球囊扩张术（EPBD）加网蓝取石联合腹腔镜胆囊切除术（LC）的治疗效果。结果全组恢复良好,住院时间5-17天,平均8.5天。均经EST或者EPBD加网蓝取石取尽肝外胆管结石,占同期EST或者EPBD加网蓝取石病人的92.85%。其中3例切开处出血,2例胰腺炎,经保守治疗治愈。LC无中转开腹。结论两镜联合治疗胆囊结石并肝外胆管结石可行性强,住院时间短,有效、安全、符合微创;先EST或者EPBD加网蓝取石后LC更适宜。

Therapy of cholecystolithiasis and extrahepatic bile duct calculus with two endoscopies association

Objective To explore the methods of treatment of cholecystolithiasis and extrahepatic bile duct calculus.Methods The effects of treatment in 78 cases with endoscopic sphinteropapillatomy(EST) or endoscopic papillary balloon dilation(EPBD)and basket net lithotomy associated with laparoscopic cholecystectomy(LC)were analyzed.Results All of the patients recovered well.The days in hospital were between 5 and 17,and 8.5 days was the average hospitalization time,All of the patients using EST or EPBD and basket net lithotomy were successful to be removed all of the stone and they were 92.85% at the same period in hospital.Five of 78 cases had complications.Conclusions Combination appliance of two endoscopies is more useful therapy for cholecystolithiasis and extrahepatic bile duct calculus and has many advantages such as mini-injury,short hospitalization time, safety and dependability.EST or EPBD associating with basket net lithotomy before LC is a more micro-trauma management.