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十二指肠镜与腹腔镜治疗肝外胆管结石手术时机的研究 被引量:20

The best operative opportunity between duodenoscopy and laparoscopic cholecystectomy in the management of calculus of extrahepatic bile duct
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摘要 目的:探讨十二指肠镜与腹腔镜治疗肝外胆管结石的最佳手术时间间隔。方法:先行十二指肠镜逆行胰胆管造影+内镜下十二指肠乳头切开术治疗胆总管结石,研究组在72h内行腹腔镜胆囊切除术;对照组在72h后行腹腔镜胆囊切除术。对比治疗后两组胆囊标本壶腹区平均中性粒细胞数,腹腔镜胆囊切除术操作时间及并发症发生率等指标。结果:研究组胆囊标本壶腹区平均中性粒细胞数少于对照组,为(3.4±1.3)vs.(7.8±1.1),(t=-14.247,P=0.000),平均手术操作时间短于对照组,为(24.6±2.8)h vs.(37.8±3.1)h,(t=-17.464,P=0.000),并发症发生率与对照组相比无显著性差异(3.2%vs.3.3%,χ2=0.000,P=1.000)。结论:逆行胰胆管造影+十二指肠乳头切开取石术与腹腔镜胆囊切除术的最佳间隔时间是<72h。 Objective:To explore the best operation opportunity between endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and laparoscopic cholecystectomy (LC) in the management of calculus of extrahepatic bile duct. Methods:First common bile duct calculi (CBDC) cured by ERCP + EST. In research group,LC was followed ERCP + EST within 72 hours and LC was followed ERCP + EST after 72 hours in control group. Contrast to the average number of neutrophil gallbladder ampulla triangle,the average time of LC operation and the postoperative complication in two groups. Results:The average number of neutrophil was fewer (3.4 ± 1.3 ) vs. (7.8 ±1.1 ), ( t = -14.247,P = 0.000) and the average time of LC was shorter in research group (24.6± 2.8) vs. (37.8 ±3.1 ) , (t = -17. 464 ,P =0.000) ,the postoperative complication was no difference in two groups(3.2% vs. 3.3% , X^2 =0. 000,P = 1. 000). Conclusions:The best operation opportunity between ERCP + EST and LC in the management of calculus of extrahepatic bile duct is within 72 hours.
作者 黄韬 郑成竹
出处 《腹腔镜外科杂志》 2008年第1期62-65,共4页 Journal of Laparoscopic Surgery
关键词 胆总管结石 内窥镜逆行胰胆管造影术 内窥镜括约肌切开术 胆囊切除术 腹腔镜 Common bile duct calculi Endoscopic retrograde cholangiopancreatography Endoscopic sphincterotomy Cholecystectomy, laparoscopic
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