One-staged and two-staged minimally invasive surgical procedures in the treatment of cholecystolithiasis complicated with choledocholithiasis

中华普通外科杂志 Pub Date : 2019-12-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2019.12.011

Guotai Wang, Xingwu Yang, Qi Wang, Xin Wang, Ning Li

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Abstract

Objective To compare the clinical efficacy of one-stage laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with primary suture (PS) and two-staged endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) followed by LC in treatment of cholecystolithiasis complicated with choledocholithiasis. Methods Of these patients, 58 received one-staged LC+ LCBDE+ PS (the one-stage group), and 71 underwent two-staged ERCP/EST followed by LC (the two-stage group). Results The surgical success rate, residual stone rate, incidence of postoperative complications and operative time showed no significant difference (χ2=0.344, 0.344, 0.108, t=-0.240, all P>0.05) in both the one-staged and two-stage groups. Compared with the two-staged group, the hospital stay was shorter (4.1d vs. 6.9d) and the total hospitalization cost was lower (23 126 yuan vs. 32 982 yuan) in the one-staged group. Conclusion Both one-staged LC+ LCBDE+ PS and two-staged ERCP/EST+ LC are safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis on base for base basis. Key words: Cholecystolithiasis; Choledocholithiasis; Cholecystectomy, Laparoscopic

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一期和两期微创手术治疗胆囊结石合并胆总管结石

目的比较一期腹腔镜胆囊切除术（LC）加一期缝合腹腔镜胆总管探查术（LCBDE）与两期内镜逆行胰胆管造影术（ERCP）/内镜乳头括约肌切开术（EST）加LC治疗胆囊结石合并胆总管结石的临床疗效。方法58例行一期LC+LCBDE+PS（一期组），71例行两期ERCP/EST后LC（两期组）。结果一期组和二期组的手术成功率、残余结石率、术后并发症发生率和手术时间差异无统计学意义（χ2=0.344，0.344，0.108，t=-0.240，均P>0.05）。与两阶段组相比，一阶段组住院时间更短（4.1d vs.6.9d），总住院费用更低（23126元vs.32982元）。结论一期LC+LCBDE+PS和两期ERCP/EST+LC治疗胆囊结石合并胆总管结石是安全有效的。关键词：胆囊结石；胆总管综合征；胆囊切除术，腹腔镜

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中华普通外科杂志

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