英文摘要12篇(2013硕士期末考试部分范围).docVIP

1. 文章来源：THE LANCET. Vol. 351. January 17, 1998 Department of Surgery, Gastrointestinal Unit, Norfolk and Norwich NHS Trust Hospital, Norwich NR1 3SR, UK (M Rhodes FRCS, L Sussman FRCS, L Cohen FRCS, M P Lewis FRCS) Randomised trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones 胆总管腹腔镜探查术与术后内镜逆行胆管造影治疗胆总管结石的随机比较试验 Summary摘要 Background: The management of stones in the common bile duct in the laparoscopic era is controversial. The three major options are preoperative endoscopic retrograde cholangiography (ERCP), laparoscopic exploration of the common bile duct (LECBD), or postoperative ERCP.（注意时态） 背景：在腹腔镜时代，处理胆总管结石是有争议的。三种主要选择是：术前内镜逆行胆管造影（ERCP），腹腔镜胆总管探查术（LECBD）,或术后内镜逆行胆管造影。 Methods: Between August, 1995, and August, 1997, 471 laparoscopic cholecystectomies were done in our department. In 427 (91%), satisfactory preoperative cholangiography was obtained. In 80 (17%) of these cases there were stones in the common bile duct. 40 patients were randomised to LECBD and 40 to postoperative ERCP. If LECBD failed, patients had either open exploration of the common bile duct or postoperative ERCP. If one postoperative ERCP failed, the procedure was repeated until the common bile duct was cleared of stones or an endoprosthesis was placed to prevent stone impaction. The primary endpoints were duct-clearance rates, morbidity, operating time, and hospital stay. Analyses were by intention to treat. 方法：1995年8月至1997年8月，471患者行腹腔镜胆囊切除术。其中427例（91%）获得满意的术前胆管造影结果。80例（17%）存在胆总管结石。40名患者随机进行了腹腔镜胆总管探查术，40名患者随机进行了术后内镜逆行胆管造影。若腹腔镜胆总管探查术失败，患者可行开腹探查胆总管或术后内镜逆行胆管造影。如一次术后内镜逆行胆管造影不行，可行多次直至清除胆总管结石或者放置内镜置管防止结石嵌顿。主要检测指标为，胆道清除率、发病率、手术时间和住院时间。统计学采用意向性分析。 Findings: Age and sex distribution of patients was similar in the randomised groups. Duct clearance after the first intervention was 75% in both groups. By the end of treatment, duct clearance was 100% in the laparoscopic group compared with 93% in the ERCP group. Du