腹腔镜胆总管探查取石术与内镜逆行胰胆管造影联合内镜十二指肠乳头括约肌切开术的近期效果和安全性比较研究
Comparative study on short-term efficacy and safety of laparoscopic common bile duct exploration and endo-scopic retrograde cholangiopancreatography combined with endoscopic duodenal papillary sphincterotomy
马东明 1顾小晖2
作者信息
- 1. 郑州大学附属郑州中心医院肝胆胰微创外科 郑州 450007
- 2. 郑州大学第二附属医院普通外科 郑州 450014
- 折叠
摘要
目的 比较分析腹腔镜胆总管探查取石术(LCBDE)与内镜逆行胰胆管造影+乳头括约肌切开术(ERCP+EST)治疗胆总管结石的近期效果和安全性.方法 回顾性分析2018-01-2023-05 两家医院收治的272 例胆总管结石患者的临床资料.按手术方式分为LCBDE组(104 例)与ERCP+EST组(168 例).比较2 组患者的近期效果及安全性.结果 LCBDE组的引流管留置时间长于ERCP+EST组,术中出血量多于ERCP+EST组,差异有统计学意义(P＜0.05);但结石一期清除率、住院时间、住院费用,以及术后高淀粉酶血症发生率和总体并发症发生率均优于ERCP+EST组.差异有统计学意义(P＜0.05).结论 与ERCP+EST相比,虽然LCBDE术的引流管留置时间更长,术中出血量更多,但其在结石一期清除率、住院时间、住院费用,以及术后并发症发生率方面更具优势.临床应根据有关指征合理选择手术方案.
Abstract
Objective To compare and analyze laparoscopic common bile duct exploration lithotomy(LCBDE)and endoscopic retro-grade cholangiopancreatography+endoscopic sphincterotomy(ERCP+EST)for the treatment of choledocholithiasis.Methods A retrospective analysis was performed for the clinical data of patients with choledocholithiasis admitted to the minimally invasive surgery of biliary and pancreat-ic in Zhengzhou Central Hospital of Zhengzhou University from 2018-01 to 2023-05.According to the surgical method,they were divided into LCBDE group(104 cases)and ERCP+EST group(168 cases).The short-term effect and safety of the two groups were compared.Results The indwelling time of drainage tubes in the LCBDE group was longer than that in the ERCP+EST group,the amount of intraoperative bleeding is more than ERCP+EST group,the difference was statistically significant(P＜0.05).The rate of primary stone clearance,the length of hospital stay,the cost of hospitalization,the incidence of postoperative hyperamy lase and the overall complication rate were better than those in the ERCP+EST group,the difference was statistically significant(P＜0.05).Conclusion Although the drainage tube indwelling time was longer than that of the ERCP+EST group and the intraoperative blood loss was higher than that of the ERCP+EST group,it had advantages in the first-stage stone clearance rate,hospital stay,hospitalization cost and postoperative complication rate.Clinically the surgical plan should be reasonably selected according to the relevant indications.
关键词
胆总管结石/腹腔镜胆总管探查取石术/逆行胰胆管造影/乳头括约肌切开术Key words
Common bile duct stones/Laparoscopic common bile duct exploration and stone removal/Retrograde cholangiopancreatog-raphy/Nipple sphincterotomy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据