腹腔镜胆总管探查取石与EST联合LC治疗胆囊结石并发细径胆总管结石的临床研究

目的比较腹腔镜下胆囊切除胆总管探查术（LC—CBDE）与内镜下oddise括约肌切开（EST）联合腹腔镜胆囊切除术（LC）治疗胆囊结石合并细径（0．8～1．2cm）胆总管结石的临床效果。方法回顾治疗胆囊结石合并细径胆总管结石58例，采用LC—CBDE术、EST联合LG术对58例患者治疗的临床资料；比较手术时间、手术费用、住院日、并发症发生率。结果两组手术总时间，手术住院日，住院总费用有显著性差异（P〈0．05）；两组结石残留卓，胆瘿发生率无显著差异（P〉0．05），但出血、胰腺炎、肠穿孔等有显著差异（P〈0．05）。结论腹腔镜下胆囊切除胆总管探查术（LC—CBDE）优于内镜下oddise括约肌切开术（EST）联合度腔镜胆囊切除术（LC）治疗胆囊结石合并细径胆总管结石。

Clinical research on LC-CBDE and EST combined LC treatment on small diameter gallstone and common bile duct stones

Objective To compare the clinical effects by laparoscopic common bile duct exploration （LC- CBDE） and oddise endoscopic sphincterotomy （EST） combined laparoscopic cholecystectomy （LC）to treat small diameter gallstone （0.8-1.2 cm） and common bile duct stones. Methods 58 cases of common bile duct stones with small diameter gallstone were treated by using LC-CBDE surgery,EST joint LG treatment of 58 cases of patients with clinical data; compared operative time,surgical costs,hospitalization,the incidence of complications. Results he total operation time,surgical hospital stay,total hospital costs of P〈 0. 05 indicated that there was a significant difference; Residual stone rate of the two groups, the incidence of biliary fistula had no significant difference （P 〉 0.05）, but the bleeding, pancreatitis,intestinal perforation, had significant differences （P 〈0.05）. Conclusions Laparoscopic common bile duct exploration （LC--CBDE） is superior to oddise endoscopic sphincterotomy （EST）eombined laparoscopic cholecystectomy （LC） in treating small diameter gallstone and common bile duct stones.