腹腔镜术中联合胰胆镜治疗胆石症疗效评价

目的　评价腹腔镜胆囊切除术 (laparoscopiccholecystectomy,LC)术中联合应用内镜括约肌切开术 (intraoperativeendoscopicsphincterotomy,IOEST)治疗胆石症的疗效。　方法　回顾性分析LC联合IOEST治疗LC术前诊断和术中常规胆道造影确诊的 6 8例胆囊合并胆总管结石患者的临床效果。　结果　联合手术成功率为 97.1% (6 6 6 8) ;IOEST成功率 98.5 % (6 7 6 8) ,取净结石率 10 0 % (6 7 6 7)。IOEST后并发轻度急性胰腺腺炎 3例 ,并发胃潴留 2例。术后平均住院时间 2 .8天。　结论　LC联合IOEST能一次性有效治疗胆囊结石合并胆总管结石 ,优于术前或术后联合EST。

Intraoperative endoscopic sphincterotomy combined with laparoscopic cholecystec tomy for the treatment of common bile duct stones Combined with gallbladder stones

Objective To evaluate the effects of intraoperative endoscopic sphincterotomy(IOEST) combined with laparoscopic cholecystectomy(LC) for common bile duct(CBD) stones. Methods Sixty eight patients with secondary CBD stones were treated by IOEST in Combination with LC.Therapeutic effects were evaluated on the basis of the cure rate, incidence of early complications and hospitalized days. Results IOEST was successfully performed in 67 of 68 cases(98.5%) and their CBD stones were cleared completely.Three cases (4.4%) were complicated with mild acute pancreatitis,and 2 cases (2.94%) with stomach stasis. Conclusions IOEST as a valid alternative for the treatment of CBD stones during LC is safe, effective and may be more beneficial to the patients than other minimally invasive surgery.