Abstract:

【Abstract】 Objective To choose the better operation time of laparoscopic cholecystectomy after the treatment by endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST). Methods A retrospective analysis was performed in 104 patients with choledocholithiasis and cholecystolithiasis from September 2008 to July 2012 in our hospital. All patients underwent ERCP/EST before laparoscopic cholecystectomy (LC), 52 cases received LC in 2 weeks (group A), and another 52 cases in 1 month (group B). The operation bleeding, postoperative complications, the total of hospitalization time and total hospitalization were compared between two groups. Results There was not statistically significant in the intraoperative amount of bleeding between the two groups.(t=0.19,P>0.05). The postoperative complications in group B was less than in Group A (x²=3.47, P<0.05), however the total hospitalization time and total hospitalization cost were lower in group A(t=2.02, 1.97,.P<0.05). Conclusion The following operation with LC in patients of post-ERCP/EST may shorten hospitalization time and lower the hospitalization costs, but increase the incidence of postoperative complications. The operation timing selection should be based on the practical situation of patients.

Key words: ERCP, EST, Laparoscopic cholecystectomy, Cholecystolithiasis, Choledocholithiasis

摘要：

【摘要】 目的 评价ERCP/EST术后2周内行腹腔镜胆囊切除术(LC)与1月后行LC治疗胆总管结石并胆囊结石的差异,探讨胆总管结石并胆囊结石外科治疗的临床选择策略。方法 回顾性分析我院自2008年9月至2012年7月我院104例胆总管结石并胆囊结石患者,均成功行内镜下逆行胰胆管造影/内镜下Oddi?蒺s括约肌切开取石术ERCP/EST,经胆道造影证实无胆总管结石残留后,择期行LC。其中52例2周内行LC患者(A组),52例1月后行LC(B组)。对两组病例的术中出血量、术后并发症、总住院时间及总住院费用进行比较分析。结果 两组术中出血量的比较,差异无统计学意义(x²=0.19,>0.05);B组术后并发症明显低于A组(?字2=3.47, P<0.05);A组总住院时间和住院费用均低于B组(x²=2.02,1.97,P<0.05)。结论 ERCP/EST术后尽早行腹腔镜胆囊切除治疗胆总管结石并胆囊结石可缩短住院时间,降低住院费用,但术后相关并发症的发生率较高,应根据患者的具体情况选择手术时间。

关键词: 内镜下逆行胰胆管造影, 内镜下Oddi’s括约肌切开取石术, 腹腔镜胆囊切除术, 胆囊结石;胆总管结石