Xia Hong-Tian, Liang Bin, Liu Yang, Yang Tao, Zeng Jian-Ping, Dong Jia-Hong
a Hospital and Institute of Hepatobiliary Surgery , Chinese PLA General Hospital, Chinese PLA Medical School , Beijing , China.
Expert Rev Gastroenterol Hepatol. 2016 Dec;10(12):1409-1413. doi: 10.1080/17474124.2016.1250623. Epub 2016 Oct 31.
We aimed to compare laparoscopic cholecystectomy (LC) and simultaneous laparoscopic transcystic common bile duct exploration (LTCBDE) using an ultrathin choledochoscope with LC followed by endoscopic retrograde cholangiopancreatography (ERC) and endoscopic sphincterotomy (ES) when indicated.
We retrospectively reviewed the records of patients seen between 2004 and 2014 and treated with LC+LTCBDE or LC for gallstones and suspected choledocholithiasis. Postoperative complications and surgical outcomes were compared using t-test, Mann-Whitney U test, or chi-square test.
115 patients underwent successful LC+LTCBDE and 112 LC; follow-up data was available for 103 and 106 patients, respectively. Seventeen patients (16.5%) in the LC+LTCBDE group and 10 (28.6%) in the LC+ERC+ES group developed complications (P = 0.114). The LC+LTCBDE group had a significantly higher rate of satisfactory biliary function outcomes than the LC+ERC+ES group (98.1% vs. 85.7%, respectively) (P = 0.017).
Single-step LC+LTCBDE using an ultrathin choledochoscope may provide better outcomes in patients with gallstones and suspected choledocholithiasis.
我们旨在比较腹腔镜胆囊切除术（LC）联合使用超薄胆道镜的同期腹腔镜经胆囊管胆总管探查术（LTCBDE）与LC，必要时联合内镜逆行胰胆管造影术（ERC）及内镜括约肌切开术（ES）的疗效。
我们回顾性分析了2004年至2014年间因胆结石及疑似胆总管结石接受LC + LTCBDE或LC治疗的患者记录。采用t检验、曼-惠特尼U检验或卡方检验比较术后并发症及手术结果。
115例患者成功接受了LC + LTCBDE，112例接受了LC；分别有103例和106例患者有随访数据。LC + LTCBDE组17例患者（16.5%）发生并发症，LC + ERC + ES组10例患者（28.6%）发生并发症（P = 0.114）。LC + LTCBDE组胆道功能满意结果的发生率显著高于LC + ERC + ES组（分别为98.1%和85.7%）（P = 0.017）。
对于胆结石及疑似胆总管结石患者，采用超薄胆道镜的单步LC + LTCBDE可能会带来更好的治疗效果。
