双镜联合切除治疗胆囊结石合并胆总管结石的分析

目的分析对胆囊结石合并胆总管结石患者应用腹腔镜胆囊切除术(LC)联合内镜联合胆总管Ⅰ期缝合治疗的结石清除、不良反应及复发率对比。方法抽选于2018年9月—2020年9月期间本院共收治的胆囊结石合并胆总管结石患者50例,按照随机掷币法均分为两组,即对照组、研究组,各25例。对照组接受LC联合胆道镜胆总管取石联合T管引流治疗,研究组接受LC联合内镜胆总管取石联合胆总管Ⅰ期缝合治疗。评价及对比两组的手术指标、结石清除情况、不良反应发生情况、术后复发情况。结果研究组的手术时长、首次肛门排气时间、住院时间、住院费用均少于对照组(P<0.05);研究组的术后不良反应率低于对照组(P<0.05);两组的手术成功率、结石残留率比较差异无统计学意义(P<0.05);研究组的复发率低于对照组(P<0.05)。结论对胆囊结石合并胆总管结石患者应用LC联合内镜联合胆总管Ⅰ期缝合治疗,可缩短住院时间,节省医疗费用,且术后不良反应少,避免结石残留复发而增加二次手术的风险,是一种高效、安全、经济的治疗选择。

Analysis of the Treatment of Cholecystolithiasis Combined With Choledocholithiasis by Double Endoscopy

Objective To analyze the clinical efficacy and adverse reactions of laparoscopic cholecystectomy(LC)combined with endoscopy combined with primary suture of common bile duct in patients with cholecystolithiasis and choledocholithiasis.Methods From September 2018 to September 2020,50 patients with cholecystolithiasis and choledocholithiasis in our hospital were selected and randomly divided into two groups,namely the control group and the study group,with 25 cases in each group.The control group received LC combined with choledochoscopic choledocholithotomy combined with T-tube drainage,while the study group received LC combined with endoscopic choledocholithotomy combined with primary suture of common bile duct.Evaluated and compared the two groups of surgical indicators,stone clearance,adverse reactions,postoperative recurrence.Results The operation time,the first anal exhaust time,hospitalization time and hospitalization expenses of the study group were less than those of the control group(P<0.05);the postoperative adverse reaction rate of the study group was lower than that of the control group(P<0.05);the operation success rate and stone residual rate of the two groups had no significant difference(P<0.05);the recurrence rate of the study group was lower than that of the control group(P<0.05).Conclusion The application of LC combined with endoscopy combined with primary suture of common bile duct in patients with cholecystolithiasis and choledocholithiasis can shorten hospitalization time,save medical expenses,reduce postoperative adverse reactions,avoid recurrence of residual stones and increase the risk of secondary operation.It is an efficient,safe and economic treatment option.