摘要
目的探讨经内镜逆行胰胆管造影术（ERCP）、内镜十二指肠乳头括约肌切开术（EST）联合腹腔镜胆囊切除术（LC）治疗胆囊结石合并胆总管结石的临床疗效。方法回顾性分析采用ERCP／EST联合LC方法治疗的40例胆囊结石合并胆总管结石的患者的临床资料。结果ERCP／EST手术成功率97．5％（39／40），1例插管失败，LC手术成功率97．4％（38／39），1例中转开腹手术，8例（20．5％）患者ERCP／EST术后出现高淀粉酶血症，无出血、胆瘘、十二指肠瘘、胆管损伤及胆道结石残留等并发症发生。61．5％（24／39）患者ERCP／EST术后2—5天行LC术，38．5％（15／39）患者ERCP／EST术后6～14天行LC术，前者在住院时间及住院费用上明显低于后者。结论ERCP／EST联合LC治疗胆囊结石合并胆总管结石安全可行，具有患者创伤小、康复快、并发症少等优点，ERCP术后尽早施行LC可减少患者住院天数及住院费用。
Objective To explore the clinical efficacy of treating cholecystolithiasis, endoscopic sphincterotomy （EST） and choledocholithiasis with endoscopic retrograde cholangiopancreatography （ERCP） combined with laparoscopic cholecystectomy（LC）. Methods The clinical data of 40 cases with holecystolithiasis and choledocholithiasis treated with ERCP/EST combined with LC were analysed retrospectively. Results The success rates of ERCP/EST were 97.5 % （59/40）, one case of failed intubation, the success rates of LC were 97.4% （38/39）, one case of conversion to open surgery, eight patients ERCP / EST postoperative were hyperamy- lasemia and weren＇ t bleeding, biliary fistula, duodenum fistula, bile duct injury and biliary stones residues and other complications. 61.5% （24/39） patients implemented LC after 2 -5 day of ERCP/EST, 38.5% （15/39） patients implemented LC after 6 - lg day of ERCP/EST, the former hospital stay and hospital costs were significantly lower than the latter. Conclusion ERCP/EST combined with LC treat cholecystolithiasis and choledocholithiasis is safe and effective, small trauma, it also will shorten complications and de- crease the complications. After ERCP, we should implement LC as soon as possible ,which will shorten the hospitalization time and hos- pital costs.
出处
《肝胆外科杂志》
2016年第4期273-275,共3页
Journal of Hepatobiliary Surgery
