腹腔镜联合内镜一期手术治疗胆囊结石合并胆总管结石

目的 探讨腹腔镜胆囊切除术中经内镜逆行胆胰管造影和十二指肠乳头括约肌切开取石一期手术(即Intra-ERCP/EST+ LC)治疗胆囊结石合并胆总管结石的优越性.方法 回顾性分析72例Intra-ERCP/EST+ LC的患者资料,选择同一时期实施先内镜逆行胆胰管造影和十二指肠乳头括约肌切开取石、再行腹腔镜胆囊切除两次手术(即Pre-ERCP/EST+ LC)的53例患者作为对照组,分析两组患者手术耗时、术后住院日、住院总费用及并发症指标.结果 与Pre-ERCP/EST+ LC组患者相比,Intra-ERCP/EST+ LC组患者术后住院日(4.20±1.56)d,t=6.420,p=0.003]、住院总费用(25332.28±1305.13)元,t=3.423,P=0.031]均明显降低,术后各并发症两组差异无统计学意义,总体并发症发病率Intra-ERCP/EST+LC组明显低于对照组(x2=16.749,P =0.000).结论 对于胆总管直径小于1.0 cm的患者,Intra-ERCP/EST+ LC一期手术能降低住院时间和住院费用,并具有微创、快速康复优势.

Clinical analysis of one-stage laparoendoscopic surgery for cholecystocholedocholithiasis

Objective To investigate the advantages of Intra-ERCP/EST + LC in the treatment of cholecystocholedocholithiasis.Methods Target on operative time consuming,post-operative hospital stay,total hospitalization costs and post-operative complications,a retrospective analysis was made beteewn 72 patients who received Intra-ERCP/EST + LC,and 53 cases as control group who received Pre-ERCP/EST + LC during the same period in our hospital.Results Compared with the Pre-ERCP/EST + LC group,post-operative hospital stay (4.20 ±1.56) days,t =6.420,P =0.003)],total hospitalization costs (25332.28 ± 1305.13) yuan,t =3.423,P =0.031)] of Intra-ERCP/EST were lower significantly,respectively.Post-operative comnplications in the two groups had no significant difference.The overall complication rate beteewn these two group was significantly difference (x2 =16.749,P =0.000).Conclusion For cholecystocholedocholithiasis patients with bile duct diameter less than 1.0 cm,one-stage Intra-ERCP/EST + LC procedue can reduce the hospitalization time and overall expenses,and has more advantages of minimally invasive and rapid recovery.