Mohseni Shahin, Ivarsson John, Ahl Rebecka, Dogan Sinan, Saar Sten, Reinsoo Arvo, Sepp Teesi, Isand Karl-Gunnar, Garder Edvard, Kaur Ilmar, Ruus Heiti, Talving Peep
Division of Trauma and Emergency Surgery, Department of Surgery, Orebro University Hospital, 701 85, Orebro, Sweden.
Orebro University, Fakultetsgatan 1, 702 81, Orebro, Sweden.
Eur J Trauma Emerg Surg. 2019 Apr;45(2):337-342. doi: 10.1007/s00068-018-0921-z. Epub 2018 Feb 7.
The timing and optimal method for common bile duct (CBD) clearance and laparoscopic cholecystectomy remains controversial. Several different approaches are available in clinical practice. The current study presents the experience of two European hospitals of simultaneous laparoscopic cholecystectomy (LC) and intra-operative endoscopic retrograde cholangiopacreatography (IO-ERCP) done by surgeons.
Retrospective analysis of all consecutive patients subjected to LC + IO-ERCP during their index admission between 4/2014 and 9/2016. Data accrued included patient demographics, laboratory markers, operation time (min) reported as mean (± SD) and hospital length of stay (LOS) reported as median (lower quartile, upper quartile).
During the 29-month study, a total of 201 consecutive LC + IO-ERCPs were performed. The mean age of patients was 55 ± 19 years and 67% were female. The mean intervention time was 105 ± 44 min. The total LOS was 4 (3, 7) days and the post-operative LOS was 2 (1, 3) days. A total of 6 (3%) patients experienced post-interventional pancreatitis and two (1%) patients suffered a Strasberg type A bile leak. All patients were successfully discharged.
Simultaneous LC + IO-ERCP is associated with few complications. Further studies investigating cost-benefit and patient satisfaction are warranted.
胆总管（CBD）清理及腹腔镜胆囊切除术的时机和最佳方法仍存在争议。临床实践中有几种不同的方法。本研究介绍了两家欧洲医院外科医生同时进行腹腔镜胆囊切除术（LC）和术中内镜逆行胰胆管造影术（IO-ERCP）的经验。
对2014年4月至2016年9月期间首次入院接受LC + IO-ERCP治疗的所有连续患者进行回顾性分析。收集的数据包括患者人口统计学资料、实验室指标、报告为均值（±标准差）的手术时间（分钟）以及报告为中位数（下四分位数，上四分位数）的住院时间（LOS）。
在为期29个月的研究中，共进行了201例连续的LC + IO-ERCP手术。患者的平均年龄为55±19岁，67%为女性。平均干预时间为105±44分钟。总住院时间为4（3，7）天，术后住院时间为2（1，3）天。共有6例（3%）患者发生介入后胰腺炎，2例（1%）患者发生Strasberg A型胆漏。所有患者均成功出院。
同时进行LC + IO-ERCP手术并发症较少。有必要进一步研究成本效益和患者满意度。
