| 彭利武1 周恩湘2 唐华1 文星均1.微创式治疗胆囊结石并胆总管结石的临床研究[J].,2011,11(12):2304-2306 |
| 微创式治疗胆囊结石并胆总管结石的临床研究 |
| Clinical Observation of Minimal Invasive Surgery for Cholecystolithiasiswith Choledocholithiasis |
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| DOI： |
| 中文关键词: 胆囊结石 胆总管结石 腹腔镜 十二指肠镜 |
| 英文关键词: Cholecystolithiasis Choledocholithiasis Laparoscopy Duodenoscope |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨腹腔镜与十二指肠镜联合治疗胆囊结石合并胆总管结石的临床应用价值。方法：74 例胆囊结合并胆总管结石患
者随机分为EST+LC 组（44 例）和OC+OCHTD 组（30 例），其中EST+LC 组行十二指肠镜Oddi 括约肌切开术（EST）加腹腔镜下
胆囊切除术（LC），OC+OCHTD 组行开腹胆囊切除术（OC）加胆总管切开取石T 管引流术（OCHTD），比较两组手术过程、术后恢
复、并发症情况等。结果：①EST+LC 组手术时间长于OC+OCHTD 组，切口长度与术中出血量少于OC+OCHTD 组（P<0.01 或
0.05）。②EST+LC 组手术成功率90.91%，取石成功率100%，OC+OCHTD 组手术成功率100%，取石成功率93.33%，两组间差异
无显著性（P>0.05）。③EST+LC 组镇痛药使用率低于OC+OCHTD 组，术后引流时间、肠鸣音恢复时间、肛门排气时间和平均住院
时间短于OC+OCHTD 组(P<0.01 或0.05)。④EST+LC 组与OC+OCHTD 组均并发症少，无结石复发。结论：十二指肠镜Oddi 括
约肌切开术联合加腹腔镜下胆囊切除术治疗胆囊结石和胆总管结石具有创伤小、恢复快、并发症少、住院时间短等优势，值得进
一步临床推广。 |
| 英文摘要: |
| Objective: To investigate the clinical value of laparoscopy combined with duodenoscope in treatment of
cholecystolithiasis with choledocholithiasis. Methods: A total of 74 cases of cholecystolithiasis with choledocholithiasis were selected, 44
cases in EST+LC group were treated with endoscopic sphincterotomy and laparoscopic cholecystectomy, 30 cases in OC+OCHTD group
with routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy. The operation procedure, postoperative
recovery and complication were compared between the two groups. Results:① In EST+LC group, operation time was longer than that in
OC+OCHTD group, but incision length and bleeding volume less than OC+OCHTD group (P<0.01 or 0.05). ② The operation succeed
rate was respectively 90.91% and 100% in EST+LC and OC+OCHTD group, stone-free rate 100% (EST+LC ) and 93.33%
(OC+OCHTD), there was no difference between the two groups (P>0.05). ③ There was significantly difference between EST+LC and
OC+OCHTD group in frequency of pain-killer use, duration of postoperative drainage, recovery of function of gastrointestinal tract, anal
exsufflation and average hospital stay (P<0.01 or 0.05). ④ Both EST+LC and OC+OCHTD group had no severe complications and
recurrence of stone. Conclusion: Endoscopic sphincterotomy and laparoscopic cholecystectomy could be widely used in clinic for
minimal invasion, .quick recovery, few complications and short hospital stay. |
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