摘要
目的探讨腹腔镜胆囊切除(laparoscopic cholecystectomy,LC)联合胆总管切开取石(laparoscopic common bile duct exploration,LCBDE)在胆囊结石合并正常直径胆总管结石患者中的应用效果。方法回顾性分析合肥市第二人民医院普通外科2014年3月至2021年7月期间通过LC联合LCBDE治疗的393例胆囊结石合并胆总管结石患者的临床资料。结果通过测量胆总管十二指肠上段直径的不同将患者分为两组。扩张组胆总管直径>8 mm,共280例,正常直径(5 mm≤胆总管直径≤8 mm)胆总管结石113例。两组在手术时间术中及术后并发症上差异无统计学意义(均P>0.05)。随访期间胆总管正常直径组结石复发3例,均通过ERCP取出。扩张组结石复发8例,7例通过ERCP取出,1例患者拒绝进一步治疗。结论在胆囊结石合并正常直径胆总管结石患者中行LC+LCBDE是安全、可行的。
Objective To evaluate laparoscopic choledocholithotomy in patients with cholecystolithiasis and normal sized common bile duct(CBD)with choledocholithiasis.Methods The clinical data of 393 patients with cholecystolithiasis and choledocholithiasis treated by LC combined with LCBDE at the Department of General Surgery of Hefei Second People's Hospital from Mar 2014 to Jul 2021 were retrospectively analyzed.Results There were 280 CBD calculi cases in which CBD diameter>8 mm which was included into CBD dilated group,and 113 cases of CBD calculi with normal diameter(5 mm≤CBD diameter≤8 mm).There was no difference in operative time and postoperative complications in the small diameter group.During the follow-up period,1 case in the dilated group experienced biliary tract stenosis and treated by stenting.There was no statistical significance in biliary tract stenosis in both groups(P>0.05).Stone recurrence occurred in 3 cases(2.7%)in the normal diameter group,all of which were removed by ERCP lithotomy.Stone recurrence occurred in 8 cases(2.9%)in the CBD dilated group,7 were removed by ERCP stone extraction and 1 refused further treatment.Conclusion It is safe and feasible to perform LC+LCBDE in patients with cholecystolithiasis complicating normal sized CBD stones.
作者
张军
李立强
姜友
李文波
李良
Zhang Jun;Li Liqiang;Jiang You;Li Wenbo;Li Liang(Department of General Surgery,the Second People's Hospital of Hefei/Hefei Hospital Affiliated to Anhui Medical University,Hefei 230011,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2023年第3期189-192,共4页
Chinese Journal of General Surgery
基金
合肥市二院光华基金。
关键词
胆囊结石病
胆总管结石病
腹腔镜胆总管切开取石
Cholecystolithiasis
Choledocholithiasis
Laparoscopic common bile duct exploration
