LC术前及术后ERCPEST治疗胆囊结石合并胆总管结石的效果比较.doc

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1、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+EST39例，LC术后行ERCP+EST30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）o术前组的

2、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）o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）-0052-04EfficacycomparisonofERCPplusESTbeforeandafter1aparoscopiccholecystectomyinthetreatmento

3、fcholelithiasiscomplicatedwithcholedocholithiasisJIANGDong-leiYANJunADONGLuSONGLangDepartmentofGeneralSurgery,theFirstAffiliatedHospitalofShanxiMedicalUniversity,Taiyuan030001,China[Abstract]ObjectiveToexploreandcomparetheefficacyofendoscopicretrogradecholangio-pancreatography(ERCP)plusendosc

4、opicsphincterotomy(EST)beforeandafterlaparoscopiccholecystectomy(LC)inthetreatmentofcholelithiasiscomplicatedwithcholedocholithiasis.Methods69casesofpatientswithcholelithiasiscomplicatedwithcholedocholithiasisintheFirstAffiliatedHospitalofShanxiMedicalUniversityandtheGeneralHospitalofTTSCOfro

5、mSeptember2009toDecember2012wereselectedandreceivedLCandERCPplusEST.39patientsreceivedERCPplusESTbeforeLCand30patientsreceivedERCPplusESTafterLC.Hospitalizationtime,incidencerateofcomplicationandtherelevantindexchangeintwogroupswascomparedrespectively.ResultsHospitalizationtimeinpreoperativeg

6、roupwasshorterthanthatinpostoperativegroup,withstatisticaldifference(P0.05).Theincidencerateofincrease1eukocytesandhyperamy1asemiainpreoperativegroupwaslowerthanthatinpostoperativegrouprespectively,withstatisticaldifference(P0.05)•ConclusionERCPplusESTcarriedoutbeforeLChasadvantagesoflesscomp

7、licationandshorterhospitalizationtime,andhasawideprospectofapplicationinthetreatmentofcholelithiasiscomplicatedwithcholedocholithiasis,whichisworthyofclinicalpromotionandapplication.[Keywords]Laparoscopiccholecystectomy;Endoscopicretrogradech