Objective To compare the treatment effect of endoscopic retrograde cholangiopancre-atography/endoscopic sphincterotomy plus laparoscopic cholecystectomy(ERCP/EST+LC)and laparoscopic cholecystectomy plus laparoscopic common bile duct exploration(LC+LCBDE)for patients with choledo-cholithiasis combined with gallbladder stones.Methods Clinical data of 172 patients with choledocholithia-sis combined with gallbladder stones treated in Heze Municipal Hospital from March 2018 to March 2021 were retrospectilvely analyzed,including 78 males and 94 females,aged(66.88±9.72)years.According to surgical method,patients were divided into the ERCP/EST+LC group(n=86)and LC+LCBDE group(n=86).The initial clearance rate of choledochal stones,operation time,intraoperative blood loss and postoperative complications were compared between the groups.Results The initial clearance rate of the choledochal stones of the ERCP/EST+LC group is 76.5％(13/17),lower than 96.3％(26/27)of LC+LCBDE group when the diameter of stones was over 1.2 cm(x2=4.07,P=0.044).When the number of choledochal stones were more than 3,the initial clearance rate of the ERCP/EST+LC group is 78.9％(15/19),lower than that of the LC+LCBDE group[96.7％(29/30),x2=3.99,P=0.046].The opera-tion time of LC+LCBDE group was longer than that of ERCP/EST+LC group[(129.07±19.33)min vs.(101.86±27.48)min,t=7.51,P＜0.001].The median intraoperative blood loss of LC+LCBDE group and ERCP/EST+LC group was 25.0(20.0,30.0)ml and 13.0(10.0,15.0)ml,respectively(Z=916.00,P＜0.001).The age,gender,maximum diameter of stones,number of stones,preoperative com-mon bile duct diameter,surgical success rate,postoperative hospital stay,total stone clearance rate,and complication rate were comparable between the groups(all P＞0.05).Conclusion Both LC+LCBDE and ERCP/EST+LC are safe and feasible for choledocholithiasis combined with cholecystolithiasis.When the maximum diameter of choledochal stones is ≥ 1.2 cm or the number of choledochal stones is≥ 3,LC+LCBDE should be favored.When patient is in poor general condition,ERCP/EST+LC might be more feasi-ble.
CholedocholithiasisGallbladder stonesEndoscopic retrograde cholangiopancre-atographyExploration of common bile duct
维普
万方数据
