腹腔镜胆总管探查取石术联合胆囊切除术治疗老年胆总管结石合并胆囊结石患者术后的临床疗效及远期随访结果

doi:10.3969/j.issn.1006-6233.2025.11.013

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摘要 目的: 评估腹腔镜胆总管探查取石术(LCBDE)联合胆囊切除术(LC)对老年胆总管结石(CBDS)合并胆囊结石患者的临床疗效及远期随访结果。方法: 2020年3月至2023年3月在我院接受治疗的老年CBDS合并胆囊结石患者根据手术方式分为ERCP+LC组(n=55)和LCBDE+LC组(n=47)。比较两组手术相关指标、术后并发症、实验室指标、远期并发症和复发率。结果: LCBDE+LC组手术时间、术中出血量、术后肛门排气时间与ERCP+LC组接近(P>0.05),腹腔引流时间长于ERCP+LC组,住院时间短于ERCP+LC组(P<0.05)。LCBDE+LC组术后并发症发生率低于ERCP+LC组(P<0.05)。两组术后6个月的实验室指标及术后2年内的远期并发症差异无统计学意义(P>0.05),LCBDE+LC组复发率低于ERCP+LC组。结论: LCBDE联合LC在老年CBDS合并胆囊结石患者中具有良好的治疗效果,可以促进恢复,缩短住院时间,减少近远期并发症发生和结石复发。

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关键词 ：胆总管结石, 胆囊结石, 腹腔镜胆总管探查取石术, 腹腔镜胆囊切除术

Abstract：Objective: To evaluate the clinical efficacy and long-term follow-up results of laparoscopic common bile duct exploration and stone removal (LCBDE) alongside laparoscopic cholecystectomy (LC) in the treatment of elderly patients with common bile duct stones (CBDS) and gallstones. Methods: Elderly patients with CBDS and gallstones who received treatment in our hospital from March 2020 to March 2023 were divided into ERCP+LC group (n=55) and LCBDE+LC group (n=47) based on surgical methods. The two groups were compared in terms of surgical related indicators, postoperative complications, laboratory indicators, long-term complications, and recurrence rates. Results: The operation time, intraoperative blood loss, and postoperative anal exhaust time of the LCBDE+LC group were similar to those of the ERCP+LC group (P>0.05), the abdominal drainage time was longer than that of the ERCP+LC group, and the hospitalization time was shorter than that of the ERCP+LC group (P<0.05). The incidence of postoperative complications in the LCBDE+LC group was lower than that in the ERCP+LC group (P<0.05). The two groups did not exhibit statistically significant differences in terms of laboratory indicators and long-term complications within two years after the surgery (P>0.05). The recurrence rate in the LCBDE+LC group was lower than that in the ERCP+LC group (P<0.05). Conclusion: LCBDE combined with LC has a good therapeutic effect in elderly patients with CBDS and gallstones, which can promote patient recovery, shorten hospitalization time, and reduce the occurrence of short - and long-term complications and stone recurrence.

Key words： Common bile duct stones Gallstones Laparoscopic exploration and stone removal of the common bile duct Laparoscopic cholecystectomy

基金资助:国家自然科学基金资助项目,(编号:82370620)

通讯作者: 李琳

引用本文:

彭琴, 王琳, 段娟丽, 张若涵, 祁文倩, 包春霞, 李琳. 腹腔镜胆总管探查取石术联合胆囊切除术治疗老年胆总管结石合并胆囊结石患者术后的临床疗效及远期随访结果[J]. 河北医学, 2025, 31(11): 1840-1843.
PENG Qin, WANG Lin, DUAN Juanli, et al. Clinical Efficacy and Long-Term Follow-up Results of Laparoscopic Common Bile Duct Exploration alongside LC for the Treatment of Elderly Patients with Common Bile Duct Stones and Gallstones after Surgery. HeBei Med, 2025, 31(11): 1840-1843.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.11.013 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I11/1840

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