Liu Hong-Dan, Zhang Qi, Xu Wen-Si, Jin Shuang
Department of Gastroenterology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang Province, China.
World J Gastrointest Surg. 2024 Jun 27;16(6):1700-1708. doi: 10.4240/wjgs.v16.i6.1700.
The incidence of cholelithiasis has been on the rise in recent years, but the choice of procedure is controversial.
To investigate the efficacy of laparoscopic cholecystectomy (LC) combined with endoscopic papillary balloon dilation (EPBD) in patients with gallbladder stones (GS) with common bile duct stones (CBDS).
The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC + EPBD group ( = 50) or an LC + endoscopic sphincterotomy (EST) group ( = 52) according to surgical methods. Surgery-related indexes, postoperative recovery, postoperative complications, and expression levels of inflammatory response indexes were compared between the two groups.
Total surgical time, stone free rate, rate of conversion to laparotomy, and successful stone extraction rate did not differ significantly between the LC + EPBD group and LC + EST group. Intraoperative hemorrhage, time to ambulation, and length of hospitalization in the LC + EPBD group were lower than those of the LC + EST group ( < 0.05). The rate of total complications of the two groups was 9.80% and 17.65%, respectively, and the difference was not statistically significant. No serious complications occurred in either group. At 48 h postoperatively, the expression levels of interleukin-6, tumor necrosis factor-α, high-sensitivity C-reactive protein, and procalcitonin were lower in the LC + EPBD group than in the LC + EST group ( < 0.05). At 3 d postoperatively, the expression levels of aspartate transaminase, alanine transaminase, and total bilirubin were lower in the LC + EPBD group than in the LC + EST group ( < 0.05).
LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS, in which LC combined with EPBD is beneficial to shorten the patient's hospitalization time, reduce the magnitude of elevated inflammatory response indexes, and promote postoperative recovery.
近年来胆石症的发病率呈上升趋势，但手术方式的选择存在争议。
探讨腹腔镜胆囊切除术（LC）联合内镜乳头球囊扩张术（EPBD）治疗合并胆总管结石（CBDS）的胆囊结石（GS）患者的疗效。
选取102例GS合并CBDS患者的临床资料进行回顾性分析，根据手术方式分为LC + EPBD组（n = 50）和LC + 内镜括约肌切开术（EST）组（n = 52）。比较两组的手术相关指标、术后恢复情况、术后并发症及炎症反应指标的表达水平。
LC + EPBD组与LC + EST组的总手术时间、结石清除率、中转开腹率及结石取出成功率差异均无统计学意义。LC + EPBD组的术中出血量、下床活动时间及住院时间均低于LC + EST组（P < 0.05）。两组的总并发症发生率分别为9.80%和17.65%，差异无统计学意义。两组均未发生严重并发症。术后48 h，LC + EPBD组白细胞介素-6、肿瘤坏死因子-α、高敏C反应蛋白及降钙素原的表达水平低于LC + EST组（P < 0.05）。术后3 d，LC + EPBD组天冬氨酸转氨酶、丙氨酸转氨酶及总胆红素的表达水平低于LC + EST组（P < 0.05）。
LC联合EPBD和LC联合EST都是治疗合并CBDS的GS的有效方法，其中LC联合EPBD有利于缩短患者住院时间，降低炎症反应指标升高幅度，促进术后恢复。
