摘要
目的比较腹腔镜胆道探查术与ERCP治疗胆囊切除术后胆总管结石的效果及复发率。方法选择我院2015年1月至2017年6月收治120例胆囊切除术后胆总管结石患者为研究对象,按随机数表法将患者分为探查组(n=60)和ERCP组(n=60)。探查组实施腹腔镜胆道探查术治疗,ERCP组实施ERCP治疗。比较两组患者手术指标、取石效果、术后恢复情况、治疗费用、术后疼痛情况、术后并发症发生情况及术后1年复发情况。结果两组患者的手术成功率、结石清除率、并发症总发生率比较,差异无统计学意义(P>0.05);ERCP组患者手术时间、术后下床活动时间、术后住院时间均短于探查组,术中出血量少于探查组,治疗费用明显低于探查组(P<0.05)。ERCP组患者术后6、24、72 h的VAS评分均明显低于探查组(P<0.05)。探查组患者急性胰腺炎发生率、术后1年结石复发率明显低于ERCP组(P<0.05)。结论腹腔镜胆道探查术与ERCP治疗胆囊切除术后胆总管结石均可达到良好的取石效果,但ERCP手术创伤更小,恢复更快,而腹腔镜胆道探查术术后结石复发风险更低。
Objective To compare the effect and recurrence rate of laparoscopic biliary exploration and ERCP on common bile duct stones after cholecystectomy.Methods A total of 120 patients with common bile duct stones after cholecystectomy treated in our hospital from January 2015 to June 2017 were selected and divided into exploration group(n=60)and ERCP group(n=60)according to the random number table method.The exploration group was treated with laparoscopic biliary exploration,and the ERCP group was treated with ERCP.The surgical indexes,stone removal effects,postoperative recovery,treatment cost,postoperative pain,postoperative complications and recurrence rates of stone at postoperative 1 year were compared between the two groups.Results There were no significant differences in the success rate of operation,stone clearance rate and total incidence of complications between the two groups(P>0.05).The operation time,postoperative ambulation time,postoperative hospital stay in the ERCP group were shorter than those in the exploration group,the intraoperative blood loss was less than that in the exploration group,and the treatment cost was lower than that in the exploration group(P<0.05).The VAS scores at postoperative 6,24,72 h in the ERCP group were lower than those in the exploration group(P<0.05).The incidence of acute pancreatitis and the recurrence rate of stones at postoperative 1 year in the exploration group were lower than those in the ERCP group(P<0.05).Conclusion The laparoscopic biliary exploration and ERCP on common bile duct stones after cholecystectomy can achieve good stone removal effect.However,ERCP has less surgical trauma and faster recovery,and laparoscopic biliary exploration has lower risk of stone recurrence.
作者
高登有
宗德宝
刘鹏飞
GAO Deng-you;ZONG De-bao;LIU Peng-fei(the People's Hospital of Wuqi County,Yan'an 717600;Affiliated Hospital of Yan'an University,Yan'an 716000,China)
出处
《临床医学研究与实践》
2019年第9期83-85,共3页
Clinical Research and Practice
