LC术前及术后ERCP+EST治疗胆囊结石合并胆总管结石的效果比较.docVIP

LC术前及术后ERCP+EST治疗胆囊结石合并胆总管结石的效果比较 　　[摘要] 目的 探讨和比较腹腔镜胆囊切除术（LC）术前行经内镜逆行性胰胆管造影术（ERCP）和内镜下括约肌切开术（EST）与LC术后行ERCP和EST治疗胆囊结石合并胆总管结石的效果。 方法 选取2009年9月～2012年12月在山西医科大学第一附属医院及太钢总医院入院的胆囊结石合并胆总管结石行LC及ERCP+EST的患者69例，其中LC术前行ERCP+EST 39例，LC术后行ERCP+EST 30例，比较两组的住院时间、并发症发生率、相关指标变化情况。 结果 术前组的住院时间短于术后组，差异有统计学意义（P0.05）。术前组的白细胞升高、高淀粉酶血症发生率均低于术后组，差异有统计学意义（P0.05）。 结论 LC术前行ERCP+EST具有并发症少、住院时间短等优点，对治疗胆囊结石合并胆总管结石具有广阔的应用前景，值得临床推广应用。 　　[关键词] 腹腔镜胆囊切除术；经内镜逆行性胰胆管造影术；内镜下括约肌切开术；胆囊结石；胆总管结石 　　[中图分类号] R575.6+2[文献标识码] A[文章编号] 1674-4721（2014）06（b）-0052-04 　　 　　Efficacy comparison of ERCP plus EST before and after laparoscopic cholecystectomy in the treatment of cholelithiasis complicated with choledocholithiasis 　　JIANG Dong-lei YAN Jun▲ DONG Lu SONG Lang 　　Department of General Surgery,the First Affiliated Hospital of Shanxi Medical University,Taiyuan030001,China 　　[Abstract] Objective To explore and compare the efficacy of endoscopic retrograde cholangio-pancreatography(ERCP)plus endoscopic sphincterotomy(EST)before and after laparoscopic cholecystectomy(LC)in the treatment of cholelithiasis complicated with choledocholithiasis. Methods 69 cases of patients with cholelithiasis complicated with choledocholithiasis in the First Affiliated Hospital of Shanxi Medical University and the General Hospital of TISCO from September 2009 to December 2012 were selected and received LC and ERCP plus EST.39 patients received ERCP plus EST before LC and 30 patients received ERCP plus EST after LC.Hospitalization time,incidence rate of complication and the relevant index change in two groups was compared respectively. Results Hospitalization time in preoperative group was shorter than that in postoperative group,with statistical difference(P0.05).The incidence rate of increase leukocytes and hyperamylasemia in preoperative group was lower than that in postoperative group respectively,with statistical difference(P0.05). Conclusion ERCP plus EST carried out before LC has advantages of less complication and s