Xie Wangcheng, Ma Zhilong, Zuo Jieliang, Gong Jian, Yu Weidi, Wang Ping, Han Wei, Song Zhenshun, Yang Tingsong
Department of General Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Langenbecks Arch Surg. 2023 May 15;408(1):195. doi: 10.1007/s00423-023-02923-3.
To analyze the benefits of laparoscopic common bile duct exploration and laparoscopic cholecystectomy (LCBDE + LC) versus endoscopic retrograde cholangiopancreatography and/or endoscopic sphincterotomy following laparoscopic cholecystectomy (ERCP/EST + LC) for difficult common bile duct stones combined with gallstones.
A retrospective analysis of consecutive patients with difficult common bile duct stones combined with gallstones in three hospitals from January 2016 to January 2021 was performed.
ERCP/EST + LC contributed to reducing postoperative drainage time. However, LCBDE + LC showed a higher rate of complete clearance, along with lower postoperative hospital stays, expenses and incidence of postoperative hyperamylasemia, pancreatitis, re-operation and recurrence. In addition, LCBDE + LC showed safe and feasible performance in the elderly and patients with previous upper abdominal surgery.
It is an effective and safe method for LCBDE + LC for difficult common bile duct stones combined with gallstones.
分析腹腔镜胆总管探查术联合腹腔镜胆囊切除术（LCBDE＋LC）与腹腔镜胆囊切除术后内镜逆行胰胆管造影术和/或内镜括约肌切开术（ERCP/EST＋LC）治疗困难胆总管结石合并胆囊结石的疗效。
对2016年1月至2021年1月期间三家医院连续收治的困难胆总管结石合并胆囊结石患者进行回顾性分析。
ERCP/EST＋LC有助于缩短术后引流时间。然而，LCBDE＋LC的结石完全清除率更高，同时术后住院时间更短、费用更低，术后高淀粉酶血症、胰腺炎、再次手术及复发的发生率也更低。此外，LCBDE＋LC在老年患者和有上腹部手术史的患者中表现出安全可行。
LCBDE＋LC是治疗困难胆总管结石合并胆囊结石的一种有效且安全的方法。
