【摘要】 目的评价腹腔镜术中Ⅰ期联合内镜逆行胆胰管造影(endoscopic retrograde cholangio pancreatography,ERCP)在治疗高龄胆囊胆管结石患者临床中的应用价值。方法选择96例高龄胆囊结石合并胆总管结石患者,按手术方法不同分为ERCP+择期腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)组46例及腹腔镜术中Ⅰ期联合ERCP组50例,比较2组手术操作时间、取石成功率、并发症发生率、住院时间、患者舒适度、住院相关费用等指标。结果 2组均成功取石,腹腔镜术中Ⅰ期联合ERCP组平均手术时间短于ERCP+择期LC组,患者舒适度优于ERCP+择期LC组,住院时间和住院总费用少于ERCP+择期LC组(P<0.01)。2组并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜术中Ⅰ期联合ERCP治疗高龄胆囊胆管结石患者,可提高其舒适度,缩短其住院时间,降低其手术费用,同时不增加其并发症发生率,为临床进一步应用提供了理论和实践依据,从而能更好地为患者服务。更多还原

【Abstract】 Objective To evaluate the value of combination of stage Ⅰ in laparoscopic surgery and endoscopic retrograde cholangiopancreatography( ERCP) in the elderly patients with gallbladder and bile duct stones. Methods Ninety-six cases of elderly patients with cholecystocholedocholithiasis,according to the different surgical methods,were divided into laparoscopic cholecystectomy + preoperative encoscopic retrograde cholangiopancreatography( 46 cases) and laparoscopic cholecystectomy + one-stage intraoperative encoscopic retrograde cholangiopancreatography( 50 cases). The operation time,successful rate of stone removal,complication and hospitalization time,patient comfort index and costs were compared in 2 groups of patients. Results The operations for two groups of patients were successful.The average operation time of combination of stage Ⅰ in laparoscopic surgery and ERCP was shorter than laparoscopic cholecystectomy + preoperative ERCP,the degree of comfort of patients was higher than that of laparoscopic cholecystectomy + preoperative ERCP group,the hospitalization time and total hospitalization costs was less than laparoscopic cholecystectomy + preoperative encoscopic retrograde cholangiopancreatography group( P < 0. 01). There was no significant difference in the incidence ofcomplications between the 2 groups( P > 0. 05). Conclusion Combination of stage Ⅰ in laparoscopic surgery and ERCP can improve patient comfort,shorten the hospitalization time,reduce the cost of surgery,also does not increase the incidence of complications,provide theoretical and practical basis for further clinical application,so as to provide the patients with better service.更多还原