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腹腔镜胆囊切除术联合经十二指肠镜逆行胆胰管造影治疗复杂肝胆管结石临床效果分析.doc

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腹腔镜胆囊切除术联合经十二指肠镜逆行胆胰管造影治疗复杂肝胆管结石临床效果分析.doc
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腹腔镜胆囊切除术联合经十二指肠镜逆 行胆胰管造影治疗复杂肝胆管结石临床 效果分析 王永平 候勇 云南省曲靖市第一人民医院普外科 摘 要: 目的:探讨腹腔镜胆囊切除术 (LC) 联合经十二指肠镜逆行胆胰管造影 (ERCP) 治疗复杂肝胆管结石临床效果及安全性。方法:收治复杂肝胆管结石患者 61例, 随机分为观察组和对照组。 观察组采用 LC联合 ERCP治疗, 对照组采用 LC治疗, 比较两组治疗效果。结果:观察组术中出血量、住院时间、首次肛门排气时间、 术后出血、术后感染和结石残留发生率均显著优于对照组 (P0.05) 。结论:LC 联合ERCP 治疗复杂性肝胆管结石能降低并发症发生率、 减少结石残留、 提高患者预后质量。 关键词: 复杂肝胆管结石; 腹腔镜胆囊切除术; 经十二指肠镜逆行胆胰管造影; Clinical effect of laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography in the treatment of complicated hepatolithiasis Wang Yongping Hou Yong Department of General Surgery, the First People's Hospital of Qujing City, Yunnan Province; Abstract: Objective:To explore the clinical effect and safety of laparoscopic cholecystectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of complicated hepatolithiasis.Methods:61 patients with complicated hepatolithiasis were selected.They were randomly divided into the observation group and the control group.The observation group was treated with LC combined with ERCP, and the control group was treated with LC.We compared the treatment effect of two groups.Results:In the observation group, the intraoperative blood loss, hospitalization time, the first anal exhaust time, postoperative bleeding, postoperative infection and residual stone incidence were significantly lower than those in the control group (P0.05) .Conclusion:LC combined with ERCP in the treatment of complicated hepatolithiasis can reduce the incidence of complications, reduce the residual stones and improve the quality of prognosis. Keyword: Complicated hepatolithiasis; Laparoscopic cholecystectomy; Endoscopic retrograde cholangiopancreatography; 胆管结石是临床常见病和多发病, 该病主要表现为溶石困难、 排石不通, 若治疗 不及时可能会引起胆汁淤积、肝硬化[1]。复杂性肝胆管结石具有极高的复发率, 是目前肝胆外科亟待攻克的重点和难点问题[2]。我院通过采用LC+ERCP 治疗复 杂性肝胆结石, 取得了较为满意的临床效果, 现报告如下。 资料与方法 2015年 5月-2017年 5月收治复杂肝胆管结石患者 61例, 并随机分为观察组和 对照组。 观察组30例, 男17例, 女13例;年龄30~70岁, 平均 (51.0±3.4) 岁
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