Abstract: 【Abstracts】〓Objective〓To compare the clinical effects between two methods for the management of cholecysto-choledocholithiasis. Methods〓From Jan 2008 to Mar 2013, a total of 153 cases of cholecysto-choledocholithiasis were treated by LCBDE (laparoscopic common bile duct exploration)+LC(laparoscopic cholecystectomy).or ERCP.(endoscopic retrograde cholangio-pancreatography)+LC. The surgical time, blood loss,.postoperative blood amylase,.total expenditure,.stones clearance rate,.complication rate were compared between two groups...Results〓LCBDE+LC group showed better than the ERCP+LC group in postoperative blood amylase,.operation failure rate, complication rate and total expenditure (P<0.05). The latter showed better in surgery time,.estimated blood loss (P<0.05). And there were no significant difference in stones clearance rate between the two groups.(P>0.05). Conclusion〓In the present study,.LCBDE+LC group had more advantages than the ERCP+LC group in postoperative blood amylase,.operation failure rate,.complication rate and total expenditure,.while we should insist on personalization options in actual practice.

Key words: Cholecysto-Choledocholithiasis, LCBDE+LC, ERCP+LC

摘要： 【摘要】〓目的〓探讨胆总管结石合并胆囊结石的两种不同处理方法的优劣比较。方法〓我科自2008年1月至2013年3月共收治153例胆总管结石合并胆囊结石的病人,分别行内镜逆行胰胆管造影(ERCP)+腹腔镜胆囊切除术(LC)或腹腔镜胆道探查取石术(LCBDE)+LC术式治疗,并对手术时间、出血量、住院费用、术后血淀粉酶、结石残留率、术后并发症发生率等指标进行统计学分析。结果〓LCBDE+LC组平均手术时间、出血量分别为103.49±22.56 min、51.04±15.05 mL,均大于ERCP+LC组(87.89±18.33 min、16.84±6.58 mL,P<0.05),术后血淀粉酶及住院费用是LCBDE+LC组小于ERCP+LC组(86.23±16.58 U/L vs 303.31±46.32 U/L,21446±8739 元 vs 25419±8953元,P<0.05),LCBDE+LC组的术后并发症发生率明显低于ERCP+LC组(5.68% vs 14.29%),中转开腹率则是高于后者(5.68% vs 0),结石残留率无显著差别(2.27% vs 1.43%)。结论〓LCBDE+LC术式在术后血淀粉酶、并发症发生率、住院费用等方面较ERCP+LC为优,但在实际诊治中,应坚持个性化选择。

关键词: 胆总管结石合并胆囊结石, LCBDE+LC, ERCP+LC