| 陈旭峰,郑扬,向正国,等.内镜逆行胰胆管造影术与腹腔镜胆总管探查术对胆总管结石的临床治疗特征比较[J].安徽医药,2023,27(3):580-583. |
| 内镜逆行胰胆管造影术与腹腔镜胆总管探查术对胆总管结石的临床治疗特征比较 |
| Comparison of clinical treatment characteristics of common bile duct stones between endoscopic retrograde cholangio-pancreatography and laparoscopic common bile duct exploration |
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| DOI：10.3969/j.issn.1009-6469.2023.03.035 |
| 中文关键词: 胆总管结石病 内镜逆行胰胆管造影术 腹腔镜胆总管探查术 临床治疗特征 并发症 复发 |
| 英文关键词: Choledocholithiasis Endoscopic retrograde cholangio-pancreatography Laparoscopic common bile duct explora?tion Clinical treatment characteristics Complications Recurrence |
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| 中文摘要: |
| 目的 比较内镜逆行胰胆管造影术(ERCP)与腹腔镜胆总管探查术(LCBDE)对胆总管结石(CBDS)的临床治疗特征。方法 回顾性纳入2017年1月至2020年12月中国人民解放军联勤保障部队第九〇四医院收治的200例CBDS病人，分析临床资料及随访资料，按照手术方式分为ERCP组(102例)与LCBDE组(98例)，比较两组病人的基线资料、围术期相关指标、术后短期并发症及复发情况。结果 ERCP组的年龄［(68.13±7.22)岁比(61.20±5.59)岁］明显高于LCBDE组(P<0.05)。LCBDE组的结石长径［(13.76±2.89)mm 比(7.58±2.34)mm］明显大于ERCP 组(P<0.05)。ERCP 组的手术时间［(105.60±18.29)min 比(86.31±13.40)min］明显长于LCBDE组(P<0.05)，术后3 d谷草转氨酶(GOT)水平高于LBCDE组(P<0.05)住院时间［(12.40±3.85)d比(17.56±4.28)d］明显短于LCBDE组(P<0.05)。ERCP组的手术成功率、复发率、术后短期并发症发生率分别为95.10%(97/102)、9.80%(10/102)、8.82%(9/102)，与LCBDE组的97.96%(96/98)、13.27%(13/98)、9.18%(9/98)比较差异无统计学意义(P>0.05)。两组之间其他指标的比较差异无统计学意义(P>0.05)。结论 ERCP与LCBDE均是治疗CBDS的有效手段，高龄病人更倾向于选择ERCP，结石长径较大者更倾向于选择LCBDE，ERCP的住院时间更短。 |
| 英文摘要: |
| Objective To compare the clinical characteristics of common bile duct stones (CBDS) between endoscopic retrograde cholangio-pancreatography (ERCP) and laparoscopic common bile duct exploration (LCBDE).Methods Clinical data and follow-up data of two hundred patients with CBDS, who were admitted to The No. 904 Hospital of the Chinese People's Liberation Army Joint Lo?gistic Support Force from January 2017 to December 2020, were retrospectively included and analyzed. Patients were assigned into ER?CP group (n=102) and LCBDE group (n=98) according to surgical methods. A comparison was made of baseline data, perioperative re?lated indexes, postoperative short-term complications and recurrence between the two groups. Results The age of ERCP group[(68.13±7.22) years vs. (61.20±5.59) years] was significantly higher than that of LCBDE group (P<0.05). The stone diameter of LCBDE group [(13.76±2.89) mm vs. (7.58±2.34) mm] was significantly longer than that of ERCP group (P<0.05). The operation time [(105.60±18.29) min vs. (86.31±13.40) min] in ERCP group was significantly longer than that in LCBDE group (P<0.05). The level of glutamic ox?alacetic transaminase (GOT) at postoperative 3 d in ERCP group was higher than that in LCBDE group (P<0.05). The length of hospital stay [(12.40±3.85) d vs. (17.56±4.28) d] in ERCP group was significantly shorter than that in LCBDE group (P<0.05). The surgical suc?cess rate, recurrence rate and postoperative short-term complication rate of ERCP group were 95.10% (97/102), 9.80% (10/102) and 8.82% (9/102), respectively, which showed no significant difference from those of LCBDE group [97.96% (96/98), 13.27% (13/98),9.18% (9/98); P>0.05]. There was no significant difference in other indexes between the two groups (P>0.05).Conclusions Both ER?CP and LCBDE are effective methods for the treatment of CBDS. Older patients are more inclined to choose ERCP, those with greater stone diameter are more inclined to choose LCBDE, and the length of hospital stay of ERCP is shorter. |
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