Study on Laparoscopic Cholecystectomy Combined with Endoscopic Sphincterotomy in the Treatment of Cholecystolithiasis Associated with Choledocholithiasis_West China Medical Journal

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Department of General Surgery,the People’s Hospital of Sichuan Province,Chengdu Sichuan 610072,China;

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Keywords：

胆石病; 腹腔镜胆囊切除术; 内镜下逆行胰胆管造影; 内镜下括约肌切开取石术

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目的:探讨腹腔镜胆囊切除术(LC)与内镜十二指肠乳头括约肌切开术(EST)联合应用治疗胆囊结石合并胆总管结石的临床效果。方法:回顾性分析我院开展的LC联合EST治疗胆囊结石合并胆总管结石76例,其中56例先行EST后行LC,20例先行LC后行ERCP/EST。结果:本组全部治愈,先行EST组56例,3例并发胰腺炎,3例出血,2例再发胆总管结石,先行LC组20例行EST11例,6例取石后未做括约肌切开,3例结石自行掉入肠道,1例出现胆道感染,1例胰腺炎,无出血及穿孔。结论:内镜治疗胆囊结石继发胆总管结石具有创伤小、效果好、并发症少、恢复快的的特点;先作EST可解除胆道梗阻、减轻炎症,并为LC创造条件,选择性先行LC后可减轻创伤,甚至不必做EST。

Citation： LUO Lanyun,ZHEN Bo,HUANG Rui,YANG Xun.. Study on Laparoscopic Cholecystectomy Combined with Endoscopic Sphincterotomy in the Treatment of Cholecystolithiasis Associated with Choledocholithiasis. West China Medical Journal, 2009, 24(9): 2254-2256. doi: Copy

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6.	周晓初,熊沛,付江华,等.腹腔镜与胆总管切开取石的前瞻性临床对比研究[J].中国微创外科杂志,2002,6(1):390-391.

1. 黄志强,主编.当代胆道外科学[M].上海:上海科技文献出版社,1998:350-361.
2. 陶涛,彭祥玉,雷俊阳,等.纤维胆道镜联合腹腔镜治疗胆总管结石(附82例)[J].中国内镜杂志,2002,8(12):4-6.
3. TANTER SE, THOMPSON MH. Comparison of endoscopic sphincterotomy and laparoscopic exploration of the common bile duct[J].BR J Surg 2002,89(12):1495-1504.
4. SOFUNI A,MAGUCHI H,ITOI T, et al.Prophylaxis of post endoscopic retrograde cholangiopancreatitis by an endoscopic pancreatic spontaneous dislodgement stent[J]. Clin Gastroenterol Hepatol, 2007,5(11):1339-1346.
5. ACOSTA JM, ROSSIR, GALLOM, et al. Early surgery for acute gallstone pancreatitis: evaluation of a system attic approach[J].Surgery,1978,83:367-370.
6. 周晓初,熊沛,付江华,等.腹腔镜与胆总管切开取石的前瞻性临床对比研究[J].中国微创外科杂志,2002,6(1):390-391.

West China Medical Journal

Study on Laparoscopic Cholecystectomy Combined with Endoscopic Sphincterotomy in the Treatment of Cholecystolithiasis Associated with Choledocholithiasis

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