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腹腔镜胆总管探查三孔技术治疗胆囊结石合并胆总管结石的回顾性研究

A Retrospective Study on the Three-Port Technique of Laparoscopic Common Bile Duct Exploration for the Management of Cholelithiasis and Choledocholithiasis.

作者信息

Zhao Chunlong, Xu Zipeng, Hu Weidong, Ge Chen, Zhang Zhengwei, Dai Zhengxing, Zhang Shuo, Tang Neng, Wang Weiguo, Gu Jiayu, Chen Chaobo, He Songbing

机构信息

Department of General Surgery, Xishan People's Hospital of Wuxi City, Wuxi, People's Republic of China.

Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.

出版信息

Int J Gen Med. 2023 Aug 11;16:3435-3445. doi: 10.2147/IJGM.S415752. eCollection 2023.

Abstract

BACKGROUND

Laparoscopic cholecystectomy (LC) with laparoscopic common bile duct exploration (LCBDE) is convenient in treating cholelithiasis and choledocholithiasis due to its advantage of accelerated recovery. This retrospective study aimed to summarize the experience of cholelithiasis and choledocholithiasis treatment via three-port approach of LCBDE in Eastern China.

METHODS

Patients diagnosed with cholelithiasis and choledocholithiasis between July 2019 and October 2021 were included. Patients who received LC+LCBDE+primary suturing of the common bile duct (CBD) via a three-port approach were assigned to the LCBDE-P group, and those who received LC+LCBDE+T-tube drainage of CBD comprised the LCBDE-T group. The measurement data were compared between the two groups. -values <0.05 indicated statistical significance.

RESULTS

A total of 88 patients were divided into two groups: LCBDE-P (n=50) and LCBDE-T (n=38). Multiple logistic regression analysis showed that LCBDE-P is associated with a shorter length of stay (OR=0.115, 95% CI: 0.040-0.329, P<0.001) and lower hospitalization costs (OR=0.120, 95% CI: 0.041-0.357, P<0.001). No significant differences between the two groups were detected in the operation time, intraoperative hemorrhage, clearance rate of CBD stones, postoperative liver function, and postoperative complications (P>0.05).

CONCLUSION

The three-port approach of LCBDE is a safe and feasible strategy for managing cholelithiasis and choledocholithiasis. Compared to LCBDE-T, LCBDE-P reduces the length of hospital stay and medical costs during hospitalization.

摘要

背景

腹腔镜胆囊切除术(LC)联合腹腔镜胆总管探查术(LCBDE)因具有促进恢复的优势,在治疗胆结石和胆总管结石方面较为便捷。本回顾性研究旨在总结中国东部地区采用三孔法LCBDE治疗胆结石和胆总管结石的经验。

方法

纳入2019年7月至2021年10月期间诊断为胆结石和胆总管结石的患者。通过三孔法接受LC+LCBDE+胆总管一期缝合的患者被分配到LCBDE-P组,接受LC+LCBDE+胆总管T管引流的患者组成LCBDE-T组。比较两组的计量资料。P值<0.05表示差异有统计学意义。

结果

共88例患者分为两组:LCBDE-P组(n=50)和LCBDE-T组(n=38)。多因素logistic回归分析显示,LCBDE-P组住院时间较短(OR=0.115,95%CI:0.040-0.329,P<0.001)且住院费用较低(OR=0.120,95%CI:0.041-0.357,P<0.001)。两组在手术时间、术中出血、胆总管结石清除率、术后肝功能及术后并发症方面差异均无统计学意义(P>0.05)。

结论

三孔法LCBDE是治疗胆结石和胆总管结石的一种安全可行的策略。与LCBDE-T相比,LCBDE-P可缩短住院时间并降低住院期间的医疗费用。

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