微创时代胆总管结石的治疗选择

目的比较腹腔镜胆总管探查取石术（LCBDE）和内镜下十二指肠括约肌切开取石术（EST）治疗胆总管结石的临床效果及医疗费用。方法回顾性分析150例胆总管结石患者经腹腔镜胆总管探查取石术或经内镜十二指肠乳头切开取石术治疗的临床资料。结果本组患者全部治愈。120例患者接受了十二指肠括约肌切开取石术，25例胆囊结石合并胆总管结石患者接受了腹腔镜胆囊切除＋胆总管切开取石术，5例胆囊切除手术史的胆总管结石患者接受了腹腔镜胆总管切开取石术。结论腹腔镜胆总管探查取石术及内镜十二指肠乳头括约切开取石术优于传统手术，但胆囊结石合并胆总管结石患者更适宜腹腔镜手术，有胆囊或胆道手术史的胆总管结石患者更适宜于经内镜途径手术。

Treatment choice for common bile duct stone in minimally surgery: LCBOE or EST

Objective To compare the outcome and total expense of laparascopic common bile duct exploration (LCBOE) and endoscopic sphincterectomy (EST) for common bile duct stone. Methed The clinical data of 150 patients with common bile duct calculi who had received laparoscopic treatment or endoscoyic treatment were analyzed retrospectively. Results All patients were cured; 120 were treated with EST, 25 were treated with LC+LCBDE, and 5 were treated with LCBDE. Conclusions Compared LCBDE with EST, LCBDE is a better choice of therapy for patients with cholecystotithiasis and common bile duct stone, EST is a better choice of therapy for those with common bile duct calculi.