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内镜下胆总管结石取出术后早期腹腔镜胆囊切除术:来自一个发展中国家的经验。

Early laparoscopic cholecystectomy after endoscopic common bile duct stone extraction: the experience from a developing country.

作者信息

Zang Jinfeng, Zhang Chi, Zhou Hongbing, Gao Junye

机构信息

Department of Hepatobiliary Surgery, Taizhou People's Hospital, Taizhou, Jiangsu, China.

出版信息

Surg Laparosc Endosc Percutan Tech. 2011 Apr;21(2):120-2. doi: 10.1097/SLE.0b013e318213c7b8.

DOI:10.1097/SLE.0b013e318213c7b8
PMID:21471806
Abstract

PURPOSE

The optimal timing of laparoscopic cholecystectomy (LC) after endoscopic common bile duct stone extraction remains controversial. The aim of this China-based retrospective study was to investigate the outcomes of patients who underwent early LC after endoscopic procedures.

METHODS

The retrospective study enrolled patients who underwent LC after endoscopic common bile duct stone extraction between January 2007 and February 2010. On the basis of intervals between LC and endoscopic procedures, patients were classified into 2 groups: early LC group, including patients receiving LC within 3 days; and delayed LC group, including patients receiving LC after 3 days. Operation time, surgical complications, postoperative hospital stay, and the cost of hospitalization were compared between 2 groups.

RESULTS

There were 92 patients in the early LC group and 115 patients in the delayed LC group. The characteristics and endoscopic procedures of the 2 groups were similar. There were no differences between the 2 groups in operative duration, incidence of surgical complications, restoration of bowel motion, postoperative hospital stay, and LC-related cost. However, total hospital cost of early LC was less than that of delayed LC.

CONCLUSIONS

Early LC after endoscopic common bile duct stone extraction in developing countries is feasible and safe. Moreover, it can reduce the total hospital cost effectively. Thus, early LC after endoscopic procedures should be recommended in developing countries.

摘要

目的

内镜下胆总管结石取出术后腹腔镜胆囊切除术(LC)的最佳时机仍存在争议。这项基于中国的回顾性研究旨在探讨内镜手术后接受早期LC患者的治疗结果。

方法

该回顾性研究纳入了2007年1月至2010年2月期间接受内镜下胆总管结石取出术后行LC的患者。根据LC与内镜手术之间的间隔时间,将患者分为两组:早期LC组,包括在3天内接受LC的患者;延迟LC组,包括在3天后接受LC的患者。比较两组的手术时间、手术并发症、术后住院时间和住院费用。

结果

早期LC组有92例患者,延迟LC组有115例患者。两组的特征和内镜手术情况相似。两组在手术持续时间、手术并发症发生率、肠道蠕动恢复、术后住院时间和LC相关费用方面无差异。然而,早期LC的总住院费用低于延迟LC。

结论

在发展中国家,内镜下胆总管结石取出术后早期行LC是可行且安全的。此外,它可以有效降低总住院费用。因此,发展中国家应推荐内镜手术后早期行LC。

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