Mijal M, Ciechański A, Chmurzyński M, Zinkiewicz K, Cwik G, Misiuna P
Kliniki Chirurgii Ogólnej II Katedry Chirurgii Akademii Medycznej w Lublinie.
Wiad Lek. 1997;50 Suppl 1 Pt 1:242-5.
Since August 1993 till December 1996, 672 patients with the gallstone disease were submitted to the laparoscopic cholecystectomy (LC). In 78 (11.7%) of them, the endoscopic sphincterotomy (ES) was performed before LC for the treatment of the coexistent obstructive jaundice caused by bile duct stones (Group I). ES was successful in 70 patients (90%). The laparoscopic cholecystectomy was done after the bilirubinemia reached the level within the normal ranges. This period (4 days to 35 days) was dependent on the level of hyperbilirubinemia at presentation. In 12 cases both procedures were performed at the same time. LC was successful in 67 patients (96%). The mean period between ES and LC was 2.7 days. The mean time of hospital stay was 6.3 days. In other 52 patients open cholecystectomy with T drainage was done for the treatment of the gall stone disease complicated by the obstructive jaundice (Group II). Comparing the two group of patients, the significantly shorter time of treatment and hospital stay as well as the lower incidence of complications was observed in Group I.
ES and LC in patients with the obstructive jaundice caused by stones results in lower morbidity and shorter time of treatment when comparing with patients treated by classical open cholecystectomy with T drainage.
自1993年8月至1996年12月，672例胆结石患者接受了腹腔镜胆囊切除术（LC）。其中78例（11.7%）在LC术前进行了内镜括约肌切开术（ES），以治疗由胆管结石引起的并存梗阻性黄疸（I组）。70例患者（90%）ES成功。在胆红素血症达到正常范围后进行腹腔镜胆囊切除术。这段时间（4天至35天）取决于就诊时高胆红素血症的水平。12例患者同时进行了这两种手术。67例患者（96%）LC成功。ES与LC之间的平均间隔时间为2.7天。平均住院时间为6.3天。另外52例患者因胆结石疾病合并梗阻性黄疸接受了开腹胆囊切除术加T管引流术（II组）。比较两组患者，I组观察到治疗时间和住院时间明显更短，并发症发生率更低。
与采用传统开腹胆囊切除术加T管引流术治疗的患者相比，结石引起梗阻性黄疸患者行ES和LC可降低发病率，缩短治疗时间。
