【摘要】 目的 比较“一步法”与“两步法”两种微创方式治疗胆囊结石合并胆总管结石的疗效。方法 216例诊断为胆囊结石合并胆总管结石的患者,根据其处理方式分为“一步法”组(A组,138例),“两步法”组(B组,78例)。比较两组患者的手术时间、术中出血量、术后住院时间、手术费用、住院费用、取石成功率、中转开腹率、术后并发症发生率等。结果 (1)两组患者的术前一般情况如年龄、结石大小等比较差异无统计学意义(P>0.05),具有可比性。(2)两组患者均无死亡病例。(3)两组患者术中出血量、取石成功率、中转开腹率及术后并发症比较差异无统计学意义(P>0.05)。(4)A组患者手术时间、术后住院时间、手术费用及住院费用上均少于B组,差异有统计学意义(P<0.05)。结论 “一步法”与“两步法”治疗胆囊结石合并胆总管结石均安全有效,但“一步法”在成本效益及患者恢复情况上更具优势。更多还原

【Abstract】 Objective To compare the surgical outcomes of one-stage surgery with two-stage surgery for cholecystolithiasis complicated with choledocholithiasis.Methods From February 2012 to December 2014,the clinical data of 216 patients with cholecystolithiasis and choledocholithiasis were randomly divided into the one-stage group(group A) and two-stage group(group B).The operative time,intraoperative blood loss,length of hospital stay,surgical costs,hospitalization costs,stone clearance,conversion to other procedures,and postoperative complications were analyzed.Results There was no significant difference between the two groups in age,stone size and other general situation(P>0.05).There was no mortality in the two groups.No significant differences were observed in terms of stone clearance,intraoperative blood loss,conversion to open surgery,and postoperative complications between the two groups(P >0.05).Group A was superior to group B in operative time,postoperative hospital stay,surgical costs and hospitalization costs(P <0.05).Conclusion Both one-stage surgery and two-stage surgery are safe and effective therapies for cholecystolithiasis complicated with choledocholithiasis.However,one-stage surgery has more advantages in recovery and cost-effectiveness.更多还原