ERCP+LC治疗胆囊结石合并胆总管结石的临床疗效观察(1)
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[摘要] 目的：探讨经内镜逆行胰胆管造影(ERCP)、联合腹腔镜胆囊切除术(LC)治疗胆囊结石并胆总管结石的临床疗效。方法：选取本院2008年10月～2010年12月收治的胆囊结石并胆总管结石患者110例，其中开腹取石治疗55例(对照组)，行ERCP联合LC治疗55例(研究组)，观察两组患者术中及术后情况，进行疗效比较。结果：研究组术中出血量少于对照组，术后住院时间、肛门排气时间、下床活动时间明显短于对照组，两组比较差异有统计学意义(P<0.05)；两组均未出现明显并发症，但术后研究组疼痛较轻，需要药物镇痛的例数少于对照组，差异有统计学意义(P<0.05)。结论：经内镜逆行胰胆管造影联合腹腔镜胆囊切除术治疗胆囊结石并胆总管结石安全有效，扩大了腹腔镜胆囊切除的范围，患者术后恢复快、创伤小，值得应用。
[关键词] 经内镜逆行胰胆管造影；腹腔镜胆囊切除术；胆囊结石；胆总管结石
[中图分类号] R575.6+2 [文献标识码] A [文章编号] 1674-4721(2012)01(b)-029-02
Clinical curative effects of ERCP+LC treating gallbladder stones combined bile duct stones
ZHAO Yongxing
Chinese Medicine Hospital of Xiangtan County in Hunan Province, Xiangtan 411100, China
[Abstract] Objective: To evaluate the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) joint laparoscopic cholecystectomy (LC) treating gallbladder stones common bile duct stones. Methods: One hundred and ten patients with common bile duct stones and gallbladder stonesin in our hospital from October 2008 to December 2010 were divided into control group (55 cases with laparotomy surgery ), and study group (55 cases with ERCP+LC treatment), to observe the intraoperative and postoperative conditions, and made efficacy comparied. Results: The blood loss of study group was less than the control group, postoperative hospital stay, time to flatus, time to ambulation were significantly shorter than the control group, the difference was statistically significant (P<0.05); and no obvious complications in both groups, but postoperative pain of study group was light, the number of patients required analgesia was less; the difference was statistically significant (P<0.05). Conclusion: The endoscopic retrograde cholangiopancreatography (MRCP) joint laparoscopic cholecystectomy treat cystic stone and bravery manager is safe and effective, expand the range of laparoscopic gallbladder remove, the postoperative recovery, small trauma, it is worth of application.
[Key words] Endoscopic retrograde cholangiopancreatography; Laparoscopic cholecystectomy; Gallbladder stones; Common bile duct stones
自1991年2月，荀祖武完成我国第一例腹腔镜胆囊切除术后，近20年来，腹腔镜手术在我国快速发展，其中腹腔镜胆囊切除术已成为治疗胆囊结石的经典微创术式。但临床约10%的胆囊结石患者合并胆总管结石，单纯腹腔镜胆囊切除术治疗不彻底，术后有一定的胆总管结石残留[1]。本文笔者采用经内镜逆行胰胆管造影(ERCP)联合腹腔镜胆囊切除术(LC)治疗胆囊结石并胆总管结石55例，效果较好，总结报道如下：
1 资料与方法
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