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经胆囊与经胆管腹腔镜胆总管探查术的比较临床结局：一项回顾性研究

Comparative clinical outcomes of transcystic vs. transductal laparoscopic common bile duct exploration: a retrospective study.

作者信息

Yang Xing-Guang, Hu Ming, Sun Wei-Feng, Zhang Tian-Liang, Yang Ji-Wu, Zhao Hui-Qiong

机构信息

Department of General Surgery II, The First Affiliated Hospital of Dali University, No. 32 of Jiashibo Avenue, Dali, Yunnan, 671000, China.

Department of Pain, The First People's Hospital of Dali, No. 36 of Tai'an Road, Dali, Yunnan, 671000, China.

出版信息

BMC Gastroenterol. 2025 Jul 1;25(1):496. doi: 10.1186/s12876-025-04063-y.

DOI:10.1186/s12876-025-04063-y
PMID:40596948
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210935/
Abstract

OBJECTIVE

This study aims to compare the therapeutic outcomes of transcystic laparoscopic common bile duct exploration (TC-LCBDE) and transductive laparoscopic common bile duct exploration (TD-LCBDE) for the treatment of common bile duct stones accompanied by gallstones.

METHODS

A cohort of 102 patients with common bile duct stones accompanied by gallstones, admitted between April 2016 and February 2025, were retrospectively analyzed. Based on the surgical approach, the patients were divided into Group A (TC-Group, n = 51) and Group B (TD-Group, n = 51). Group A underwent TC-LCBDE, while Group B underwent TD-LCBDE. Key parameters were statistically analyzed, including operative duration, intraoperative blood loss, postoperative length of stay, average hospitalization cost, postoperative drainage tube indwelling time, and the incidence of postoperative complications.

RESULTS

Group A had a shorter postoperative length of stay compared to Group B (P < 0.05). The total hospitalization cost in Group A was also lower than that in Group B (P < 0.05). Additionally, the postoperative drainage tube indwelling time was shorter in Group A, with a statistically significant difference between the two groups (P < 0.05).

CONCLUSION

TC-LCBDE is an optimal surgical approach for treating common bile duct stones with concomitant gallstones, offering faster postoperative recovery, lower hospitalization costs, shorter hospital stays, and reduced drainage tube indwelling time.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

目的

本研究旨在比较经胆囊腹腔镜胆总管探查术（TC-LCBDE）和经导管腹腔镜胆总管探查术（TD-LCBDE）治疗胆总管结石合并胆囊结石的疗效。

方法

回顾性分析2016年4月至2025年2月收治的102例胆总管结石合并胆囊结石患者。根据手术方式，将患者分为A组（TC组，n = 51）和B组（TD组，n = 51）。A组行TC-LCBDE，B组行TD-LCBDE。对手术时间术中出血量、术后住院时间、平均住院费用、术后引流管留置时间及术后并发症发生率等关键参数进行统计学分析。

结果

A组术后住院时间较B组短（P < 0.05）。A组总住院费用也低于B组（P < 0.05）。此外，A组术后引流管留置时间较短，两组间差异有统计学意义（P < 0.05）。

结论

TC-LCBDE是治疗胆总管结石合并胆囊结石患者的一种最佳手术方式，术后恢复更快、住院费用更低、住院时间更短且引流管留置时间缩短。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/c549957a9967/12876_2025_4063_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/55ee744fa901/12876_2025_4063_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/66f97b3eff48/12876_2025_4063_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/7c05bcb70422/12876_2025_4063_Fig3_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/bbc1455655e5/12876_2025_4063_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/c549957a9967/12876_2025_4063_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/55ee744fa901/12876_2025_4063_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/66f97b3eff48/12876_2025_4063_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/7c05bcb70422/12876_2025_4063_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/0d0ee19dccf3/12876_2025_4063_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/bbc1455655e5/12876_2025_4063_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb0/12210935/c549957a9967/12876_2025_4063_Fig6_HTML.jpg

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本文引用的文献

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J Laparoendosc Adv Surg Tech A. 2023 Mar;33(3):276-280. doi: 10.1089/lap.2022.0408. Epub 2022 Dec 1.
2
Laparoscopic transcystic common bile duct exploration in patients with a nondilated common bile duct.腹腔镜经胆囊管胆总管探查术在无扩张胆总管患者中的应用。
Ann Palliat Med. 2021 Dec;10(12):12845-12856. doi: 10.21037/apm-21-3609.
3
Transductal versus transcystic laparoscopic common bile duct exploration: an institutional review of over four hundred cases.
经导管与经胆囊腹腔镜胆总管探查术：一项超过400例病例的机构回顾
Surg Endosc. 2021 Jan;35(1):437-448. doi: 10.1007/s00464-020-07522-7. Epub 2020 Apr 3.
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Comparison between endoscopic sphincterotomy endoscopic sphincterotomy associated with balloon dilation for removal of bile duct stones: A systematic review and meta-analysis based on randomized controlled trials.内镜括约肌切开术与内镜括约肌切开术联合球囊扩张术治疗胆管结石的比较：基于随机对照试验的系统评价和荟萃分析。
World J Gastrointest Endosc. 2018 Aug 16;10(8):130-144. doi: 10.4253/wjge.v10.i8.130.
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Japan Gastroenterological Endoscopy Society guidelines for endoscopic sphincterotomy.日本消化内镜学会内镜下括约肌切开术指南。
Dig Endosc. 2018 Mar;30(2):149-173. doi: 10.1111/den.13001. Epub 2018 Jan 18.
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Sphincter of Oddi Function and Risk Factors for Dysfunction.Oddi括约肌功能及功能障碍的危险因素。
Front Nutr. 2017 Jan 30;4:1. doi: 10.3389/fnut.2017.00001. eCollection 2017.
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Laparoscopic Transcystic Common Bile Duct Exploration: Advantages over Laparoscopic Choledochotomy.腹腔镜经胆囊管胆总管探查术：相较于腹腔镜胆总管切开术的优势
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