| 陈永艺,陈华福,錡和强,钟 伟,邹燕慧.ERCP/EST-LC治疗胆囊结石合并胆总管结石临床疗效及并发症[J].,2021,(5):867-870 |
| ERCP/EST-LC治疗胆囊结石合并胆总管结石临床疗效及并发症 |
| Clinical Efficacy and Complications of ERCP/EST-LC in the Treatment of Gallstones Combined with Choledocholithiasis |
| 投稿时间：2020-08-06 修订日期：2020-08-31 |
| DOI：10.13241/j.cnki.pmb.2021.05.013 |
| 中文关键词: ERCP/EST-LC 胆囊结石 胆总管结石 疗效 并发症 |
| 英文关键词: ERCP/EST-LC Gallbladder stones Common bile duct stones Curative effect Complications |
| 基金项目:全军后勤科研面上项目(CWH17J030) |
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| 中文摘要: |
| 摘要 目的：考察内镜下逆行胰胆管造影术/十二指肠乳头括约肌切开术加腹腔镜胆囊切除术(endoscopic retrograde pancreatic angiography/endoscopic sphincterotomy-1aparoscopic cholecystectomy，ERCP/EST-LC)对胆囊结石合并胆总管结石的临床疗效和安全性。方法：选80例胆囊结石合并胆总管结石患者，随机数字表法分为两组，每组40例，对照组进行LCBDE-LC手术，研究组进行ERCP/EST-LC手术，以手术成功率、围术期相关指标和术后并发症等指标考察对患者的临床疗效。结果：对照组手术成功率为95.0 %，研究组患者手术成功率为97.5 %，两组无显著差异（P＞0.05），研究组患者的手术时间和术中出血量与对照组相比均无显著差异(P＞0.05)，研究组胃肠功能恢复时间为39.64±5.34 h，显著长于对照组的37.19±3.17 h (P＜0.05)，研究组住院时间为14.17±2.06 d，显著长于对照组的11.85±2.71 d (P＜0.05)。两组患者的胆道感染、急性胰腺炎、肠穿孔、结石残留以及胆管炎的发生率无显著差异 (P＞0.05)，对照组胆漏发生率为7.50 %，显著高于研究组的0.00 % (P＜0.05)，而研究组术后出血发生率为10.00 %，显著高于对照组的2.50 % (P＜0.05)，对照组并发症总发生率为12.50 %，研究组为15.00 %，两组比较无显著差异(P＞0.05)。对照组术后一年复发率为15.00 %，研究组的复发率为17.50 %，经统计分析，两组术后复发率无显著差异(P＞0.05)，其余患者无腹痛、发热、黄疸等情况。结论：ERCP/EST-LC治疗胆囊结石合并胆总管结石临床疗效确切、并发症少，安全性高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical efficacy and safety of ERCP/EST-LC on gallbladder stones combined with common bile duct stones. Methods: Taking 80 patients with gallbladder stones and common bile duct stones as the research objects, they were divided into the study group and the control group by random number table method, with 40 cases in each group. The control group underwent LCBDE-LC surgery, and the study group underwent ERCP/EST-LC surgery. The clinical efficacy of patients was investigated by indicators such as surgical success rate, perioperative indicators and postoperative complications. Results: The operation success rate of the control group was 95.0 %, and the operation success rate of the study group was 97.5 %. There was no significant difference between the two groups (P>0.05). There was no significant difference in the operation time and intraoperative blood loss of the study group compared with the control group. (P>0.05), the recovery time of gastrointestinal function in the study group was 39.64±5.34 h, which was significantly longer than 37.19±3.17 h in the control group (P＜0.05), and the hospital stay in the study group was 14.17±2.06 d, which was significantly longer than the control group 11.85±2.71 d (P＜0.05). There was no significant difference in the incidence of biliary tract infection, acute pancreatitis, intestinal perforation, residual stones, and cholangitis between the two groups (P>0.05). The incidence of bile leakage in the control group was 7.50 %, which was significantly higher than the 0.00 % in the study group (P＜0.05), and the incidence of postoperative bleeding in the study group was 10.00 %, which was significantly higher than 2.50 % in the control group (P＜0.05). The total incidence of complications was 12.50 % in the control group, and 15.00 % in the study group. There was no significant difference between the two groups (P>0.05). The one-year recurrence rate of the control group was 15.00 %, and the recurrence rate of the study group was 17.50 %. According to statistical analysis, there was no significant difference in the recurrence rate between the two groups (P>0.05). The remaining patients had no abdominal pain, fever, jaundice. Conclusion: ERCP/EST-LC treatment of gallbladder stones combined with choledocholithiasis has definite clinical curative effect, few complications and high safety. |
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