摘要
目的 探究腹腔镜胆囊切除术(LC)联合不同手术时机内镜逆行性胰胆管造影术(ERCP)对胆囊结石合并胆总管结石的效果及对急性胰腺炎发生率、高淀粉酶血症发生率的影响。方法 选取 2015年 9月到2017年 9月期间收治的98例胆囊结石合并胆总管结石患者为研究对象。随机分为观察组(49例)和对照组(49例)。观察组患者在LC术前行ERCP+内镜下括约肌被切开术(EST),对照组患者在LC术后行ERCP+EST。采用SPSS 20.0统计软件分析,两组患者围术期的相关指标、肝功能指标采用(±s)表示,独立样本t检验;取石成功率和并发症发生率采用χ 2检验;P <0.05表示差异有统计学意义。结果 两组患者术中出血量、取石成功率及住院、排气、平均手术时间差异无统计学意义( P >0.05);两组患者术前1 d、术后3 d 肝功能指标组间差异无统计学意义( P >0.05);术后观察组患者的急性胰腺炎、发热率、高淀粉酶血症和白细胞计数升高例数均少于对照组( P <0.05)。结论 在LC 术前行ERCP+EST 治疗胆囊结石合并胆总管结石,具有住院时间短和并发症少等优点,值得在临床推广应用。
Objective To explore the effect of laparoscopic cholecystectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) at different operation time for cholecystolithiasis combined with choledocholithiasi and the incidence of acute pancreatitis and hyperamylasemia. Methods From September 2015 to September 2016, 98 patients with cholecystolithiasis combined with choledocholithiasi were randomly divided into observation group (49 cases) and, into the control group (49 cases). The patients in the observation group received ERCP+EST before LC, while those in the control group underwent ERCP+EST after LC. SPSS 20.0 software was used for data analysis. Measurement data such as perioperative related indicators and liver functions were expressed as (±s) and were examined by independent t test. The success rate and complication rate were examined by chi square test. A P value of <0.05 was considered as statistically significant. Results There were no significant difference in the intraoperative blood loss, the success rate of stone removal, hospitalization, exhaust and average operation time between the two groups ( P >0.05). There were no significant difference in liver functions of ALP, ALB, TB and ALT between the two groups at 1 day before operation and 3 days after operation ( P >0.05). The acute pancreatitis, hyperamylasemia, fever and elevated white blood cell in the observation group were significantly better than those in the control group respectively ( P <0.05). Conclusion ERCP + EST before LC in the treatment of cholecystolithiasis combined with choledocholithiasis has the advantages of shorter hospitalization time and less complications, which is worthy of clinical application.
作者
姜鹏飞
顾澄宇
Jiang Pengfei;Gu ChengYu(The first department of surgery, Yangzhou Friendship Hospital, Jiangsu 225261, China;Department of hepatobiliary surgery, Wuxi people’s Hospital, Jiangsu 214023, China)
出处
《中华普外科手术学杂志（电子版）》
2019年第5期479-481,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
国家自然科学基金青年项目(81302105)~~
关键词
胆囊结石病
胆总管结石
胆囊切除术
腹腔镜
胰胆管造影术
内窥镜逆行
Cholecystolithiasis
Choledocholithiasis
Cholecystectomy, laparoscopic
Cholangiopancreatography, endoscopic retrograde
