河北医科大学学报

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评价腹腔镜术中Ⅰ期联合ERCP在高龄胆囊胆管结石患者中的应用价值

  

  1. 河北医科大学第二医院肝胆外科,河北 石家庄 050000
  • 出版日期:2016-11-25 发布日期:2016-12-14
  • 作者简介:陈圣雄( 1985- ),男,福建仙游人,河北医科大学第二医院主治医师,医学硕士,从事肝胆外科疾病诊治研究。

Evaluation of the value of combination of stage Ⅰ in laparoscopic surgery and ERCP in the elderly patients with gallbladder and bile duct stones

  1. Department of Hepatobiliary Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Online:2016-11-25 Published:2016-12-14

摘要: [摘 要 ] 目 的
评 价 腹 腔 镜 术 中 Ⅰ 期 联 合 内 镜 逆 行 胆 胰 管 造 影 ( endoscopicretrogradecholangio
pancreatography , ERCP )在治疗高龄胆囊胆管结石患者临床中的应用价值。方法 选择 96 例高龄胆囊结石合并胆
总管结石患者,按手术方法不同分为 ERCP+ 择期腹腔镜胆囊切除术( laparoscopiccholecystectomy , LC )组 46 例及
腹腔镜术中 Ⅰ 期联合 ERCP 组 50 例,比较 2 组手术操作时间、取石成功率、并发症发生率、住院时间、患者舒适度、
住院相关费用等指标。结果 2 组均成功取石,腹腔镜术中 Ⅰ 期联合 ERCP 组平均手术时间短于 ERCP+ 择期 LC
组,患者舒适度优于 ERCP+ 择期 LC 组,住院时间和住院总费用少于 ERCP+ 择期 LC 组( P <0.01 )。 2 组并发症
发生率差异无统计学意义( P >0.05 )。结论 腹腔镜术中 Ⅰ 期联合 ERCP 治疗高龄胆囊胆管结石患者,可提高其舒
适度,缩短其住院时间,降低其手术费用,同时不增加其并发症发生率,为临床进一步应用提供了理论和实践依据,
从而能更好地为患者服务。

关键词: 胆结石, 腹腔镜检查, 胰胆管造影术, 内窥镜逆行

Abstract: [
Abstract ] Objective Toevaluatethevalueofcombinationofstage Ⅰ inlaparoscopic
surgeryandendoscopicretrogradecholangiopancreatography ( ERCP ) intheelderlypatientswith
gallbladder and bile duct stones.Methods Ninety-six cases of elderly patients with
cholecystocholedocholithiasis , accordingtothedifferentsurgical methods , weredividedinto
laparoscopiccholecystectomy+preoperativeencoscopicretrogradecholangiopancreatography ( 46
cases ) and laparoscopic cholecystectomy + one-stage intraoperative encoscopic retrograde
cholangiopancreatography ( 50cases ) .Theoperationtime , successfulrateofstoneremoval
,
complicationandhospitalizationtime , patientcomfortindexandcostswerecomparedin2groups
ofpatients.Results Theoperationsfortwogroupsofpatientsweresuccessful.Theaverage
operationtimeofcombinationofstage ⅠinlaparoscopicsurgeryandERCP wasshorterthan
laparoscopiccholecystectomy+preoperativeERCP , thedegreeofcomfortofpatientswashigher
thanthatoflaparoscopiccholecystectomy+preoperativeERCPgroup , thehospitalizationtimeand
totalhospitalizationcostswaslessthanlaparoscopiccholecystectomy+preoperativeencoscopic etrogradecholangiopancreatographygroup ( P <0.01 ) .Therewasnosignificantdifferenceinthe
incidenceofcomplicationsbetweenthe2groups ( P >0.05 ) .Conclusion CombinationofstageⅠ
inlaparoscopicsurgeryandERCPcanimprovepatientcomfort , shortenthehospitalizationtime ,
reducethecostofsurgery , alsodoesnotincreasetheincidenceofcomplications , provide
theoreticalandpracticalbasisforfurtherclinicalapplication , soastoprovidethepatientswith
betterservice.

Key words: cholecystocholedocholithiasis , laparoscopy , cholangiopancreatography, endoscopic
retrograde