临床外科杂志 ›› 2021, Vol. 29 ›› Issue (7): 622-625.doi: 10.3969/j.issn.1005-6483.2021.07.008

• • 上一篇    下一篇

腹腔镜胆总管切开探查取石+腹腔镜胆囊切除术与经内镜逆行胰胆管造影/内镜下括约肌切开取石+腹腔镜胆囊切除术治疗结石性急性梗阻性化脓性胆管炎的疗效比较

  

  1. 201600 上海交通大学医学院附属松江医院消化外科
  • 出版日期:2021-07-20 发布日期:2021-07-20

Comparison of the curative effect of LCBDE+LC and ERCP/EST+LC in the treatment of calculous acute obstructive suppurative cholangitis

  1. Department of Digestive Surgery,Songjiang Hospital affillated to Shanghai Jiaotong University School of Medicine,Shanghai 201600,China
  • Online:2021-07-20 Published:2021-07-20

摘要: 目的  比较腹腔镜胆总管切开探查取石(LCBDE)+腹腔镜胆囊切除术(LC)和经内镜逆行胰胆管造影/内镜下括约肌切开取石(ERCP/EST)+LC两种微创术式治疗结石性急性梗阻性化脓性胆管炎(AOSC)的临床疗效。
方法  结石性AOSC病人70例,按治疗方式分为LCBDE+LC组(36例)和ERCP/EST+LC组(34例),比较两组手术总成功率、一次手术成功率、手术时间、术中出血量、术后并发症发生率、住院时间及住院费用方面的差异。
结果  LCBDE+LC组一次手术成功率高于ERCP/EST+LC组,住院时间和住院费用少于ERCP/EST+LC组,但术中出血量多于ERCP/EST+LC组,差异有统计学意义(P<0.05),两组手术总成功率、手术时间及术后并发症发生率的比较,差异均无统计学意义(P>0.05)。
结论  LCBDE+LC比ERCP/EST+LC治疗结石性AOSC一次手术成功率高、住院时间短、住院费用低。

关键词: 急性梗阻性化脓性胆管炎, 结石, 腹腔镜手术, 内镜治疗, 疗效

Abstract: Objective To compare the clinical effect of laparoscopic common bile duct exploration and stone extraction(LCBDE) combined with laparoscopic cholecystectomy(LC) compared with endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomy(ERCP/EST) combined with laparoscopic cholecystectomy(LC) in the treatment of calcalous acute obstructive suppurative cholangitis(AOSC).
Methods The clinical data of 70 patients with calcalous AOSC in Songjiang Hospital affillated to Shanghai Jiaotong University School of Medicine were analyzed retrospectively.The cases were divided into the LCBDE+LC group(36 cases) and the ERCP/EST+LC group(34 cases) according to different treatment methods.The total operative success rate,primary operative success rate,operation time,intraoperative bleeding volume,postoperative complications rate,hospitalization time and hospitalization cost of the two groups were compared.
Results In LCBDE+LC group,the success rate of primary operation was higher than that of ERCP/EST+LC group,the length and cost of hospital stay were less than that of ERCP/EST+LC group,but the intraoperative bleeding volume was more than that of ERCP/EST+LC group.The difference was statistically significant(P<0.05).There were no differences in the total operative success rate,operation time and postoperative complications rate between LCBDE+LC group and ERCP/EST+LC group(P>0.05).
Conclusions Compared with ERCP/EST+LC in the treatment of calcalous AOSC,LCBDE+LC has the advantages of higher success rate of primary operation,shorter hospitalization time and lower hospitalization cost.

Key words: acute obstructive suppurative cholangitis, calculus, laparoscopic surgery, endoscopic therapy, curative effect

[1] 王黎, 姚启盛, 陈从波等. 肾结石并肾盂鳞癌六例[J]. 临床外科杂志, 2021, 29(8): 764-766.
[2] 辛国军 王建承 翁原驰 张俊. 全胰腺切除术9例临床疗效分析[J]. 临床外科杂志, 2021, 29(7): 619-621.
[3] 熊添 樊宏 赵基鹏 李昊. 不同剂型丙泊酚对直肠癌腹腔镜手术病人内皮系统和生化功能的影响[J]. 临床外科杂志, 2021, 29(7): 669-672.
[4] 李鑫, 顾绍栋, 罗洪等. 治疗性血管新生在尿道下裂手术中的应用分析[J]. 临床外科杂志, 2021, 29(6): 514-516.
[5] 王磊, 刘康伟, 段玉灵等. 老年胆囊结石并胆总管结石病人经内镜下逆行胰胆管造影术后序贯腹腔镜胆囊切除术治疗手术时机的研究[J]. 临床外科杂志, 2021, 29(6): 559-561.
[6] 李干斌 韩加刚 王振军 魏广辉 渠浩 翟志伟 易秉强 马华崇 杨勇王建良 李竹林. 新辅助放化疗治疗局部进展期直肠癌的远期疗效及预后因素分析[J]. 临床外科杂志, 2021, 29(5): 422-427.
[7] 罗刚 江帆 黄子锋 林一煌. 腹腔镜下胆囊切除术联合经腹顺行导丝引导逆行胰胆管造影术取石治疗胆囊结石合并细径胆总管结石的疗效分析[J]. 临床外科杂志, 2021, 29(5): 466-469.
[8] 隋金珂 张卫. 腹腔镜结直肠手术的现状[J]. 临床外科杂志, 2021, 29(5): 492-494.
[9] 陈颖, 余佳, 王卫星. 腹腔镜微创技术在肝外胆管结石治疗中的应用策略[J]. 临床外科杂志, 2021, 29(4): 396-398.
[10] 吕远, 许长宝, 万优. 摩西技术120W钬激光“三线一面”法在高风险良性前列腺增生合并膀胱结石治疗中的体会[J]. 临床外科杂志, 2021, 29(2): 117-119.
[11] 胡俊杰, 达娃, 多吉扎西. 西藏高原地区泌尿系统结石成分及临床特征分析[J]. 临床外科杂志, 2021, 29(2): 126-128.
[12] 孙茂坤, 刘荷臣, 程琳. 双镜联合一期治疗重复肾盂输尿管连接部梗阻合并多发肾结石一例[J]. 临床外科杂志, 2021, 29(2): 129-131.
[13] 王全晖, 拜云虎, 袁守信. 双镜联合治疗胆总管结石术中不同一期缝合方式对病人的疗效及预后的影响评估[J]. 临床外科杂志, 2021, 29(2): 181-183.
[14] 聂金琳, 张浩然, 陈长顺. Castleman病三例[J]. 临床外科杂志, 2021, 29(2): 199-200.
[15] 蒋少华 路晓军 冯文强 高磊. 钬激光低频低能联合输尿管导管引流在输尿管上段结石输尿管镜碎石中的应用[J]. 临床外科杂志, 2021, 29(1): 61-63.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 李光焰;张安平;王祥峰;等. 直肠癌切除术后吻合口狭窄14例分析[J]. 临床外科杂志, 2016, 24(10): 772 .
[2] 肖国栋;刘国辉. 跗骨窦切口联合经皮置钉技术微创治疗跟骨骨折的临床疗效分析[J]. 临床外科杂志, 2016, 24(10): 783 .
[3] 李阳;胡元祥;胡季明;等. 甲状腺结核11例临床分析[J]. 临床外科杂志, 2016, 24(11): 888 .
[4] 柯文波;李童;郑启昌. ω-3多不饱和脂肪酸对肝癌患者术后免疫代谢的影响[J]. 临床外科杂志, 2016, 24(12): 905 .
[5] 谭海洋;罗良弢;严想元. 肠内营养与肠外营养在腹腔镜胃肠道肿瘤患者术后早期应用的临床研究[J]. 临床外科杂志, 2016, 24(12): 910 .
[6] 刘智化;陈坚;刘绪舜. 超声引导下冷循环微波消融治疗甲状腺微小癌的临床价值[J]. 临床外科杂志, 2016, 24(12): 934 .
[7] 邹长林;许州;刘超;等. 单侧额下入路显微切除大型及巨大型嗅沟脑膜瘤[J]. 临床外科杂志, 2016, 24(12): 946 .
[8] 杨晓辉;郑淑月;马云改;等. 医用臭氧联合类固醇激素治疗慢性腰椎间盘源性疼痛临床分析[J]. 临床外科杂志, 2016, 24(12): 954 .
[9] 杨新;吴会生;王焱林. 纳美芬在脊柱侧弯矫形术术中唤醒中的应用[J]. 临床外科杂志, 2016, 24(12): 957 .
[10] 胡均贤 徐春林 吴雅兰 . 高血压脑出血微创穿刺清除术后手术相关并发症及预后分析 [J]. 临床外科杂志, 2016, 24(4): 318 .