内镜联合探查在老年胆囊结石合并胆总管结石患者治疗中的疗效及安全性。

Efficacy and safety of double endoscopy combined with exploration in the treatment of elderly patients with cholecystolithiasis complicated with choledocholithiasis.

机构信息

Department of General Surgery, Daxing Hospital of Capital Medical University, No.26, West Street, Huangcun Town, Daxing District, Beijing, 102600, China.

出版信息

BMC Surg. 2024 Feb 20;24(1):67. doi: 10.1186/s12893-024-02352-z.

Abstract

OBJECTIVE

To investigate the efficacy and safety of laparoscopy combined with choledochoscopy in the treatment of elderly patients with cholecystolithiasis complicated with choledocholithiasis.

METHODS

A retrospective analysis of 114 patients admitted to our hospital from January 2020 to January 2023 was conducted. These patients underwent laparoscopic cholecystectomy combined with choledocholithiasis and were divided into an elderly group (≥ 60 years old) of 63 cases and a young and middle-aged group (< 60 years old) of 51 cases according to age. The efficacy and safety indicators of the two groups of patients were observed, and complications were followed up by telephone within 6 months after surgery. The follow-up deadline was June 2023.

RESULTS

Among the eligible patients (53 men, 61 women, average age 57 years), all were successfully operated, and 1 case was converted to laparotomy. The elderly and young and middle-aged groups were compared concerning hospitalisation time, bowel sound recovery time, and total postoperative complications, and the differences were statistically significant (P-values were 0.009, 0.006, and 0.039). However, there was no statistically significant difference between the two groups of patients in terms of hospitalisation costs, intraoperative blood loss, operation time, drainage tube removal time, conversion to laparotomy rate, and stone clearance rate (P-values > 0 0.05).

CONCLUSION

Strict adherence to surgical standards and enhanced postoperative care resulted in similar efficacy and safety results for double endoscopy combined with the exploration of treatment for elderly and young patients with cholecystolithiasis and choledocholithiasis.

摘要

目的

探讨腹腔镜联合胆道镜治疗老年胆囊结石合并胆总管结石的疗效及安全性。

方法

回顾性分析 2020 年 1 月至 2023 年 1 月我院收治的 114 例患者,均行腹腔镜胆囊切除术联合胆总管探查术,根据年龄分为老年组(≥60 岁)63 例和中青年组(<60 岁)51 例。观察两组患者的疗效及安全性指标,术后 6 个月内电话随访并发症。随访截止日期为 2023 年 6 月。

结果

纳入的 114 例患者(男 53 例,女 61 例,平均年龄 57 岁)均顺利完成手术,1 例中转开腹。比较两组患者的住院时间、肠鸣音恢复时间及总术后并发症,差异有统计学意义(P 值分别为 0.009、0.006 和 0.039)。但两组患者的住院费用、术中出血量、手术时间、引流管拔除时间、中转开腹率及结石清除率比较,差异无统计学意义(P 值均>0.05)。

结论

严格遵循手术标准并加强术后护理,使老年和中青年患者接受双镜联合胆道探查术治疗胆囊结石合并胆总管结石的疗效和安全性相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3728/10880308/b25331e5b699/12893_2024_2352_Fig1_HTML.jpg

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