两种手术方式治疗胆总管结石伴急性胆管炎及胆囊结石的效果评价

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[中图分类号] ; [文献标志码] A [文章编号] 2096-532（2025）02-0239-04 doi：10.1712/jms.2096-532.2025.61.038

[Abstract] Objective Toinvestigatetheeficacyofendoscopicretrogradecholangiopancreatography/endoscopicsphincterotomy（ERCP/EST）combinedwithlaparoscopiccholecystectomy（LC）inthetreatmentofcholedocholithiasiswithacutecholangitis andgalstones. Methods Atotalof76patientswithcholedocholithiasiswithacutecholangitisandcholecystolithiasiswhounderwentsurgicaltreatmentinChizhouPeople’sHospitalfromJanuary2020toSeptember2023wereenroledassubjects，andthey weredividedintocontrolgroupandobservationgroupusingarandomnumbertable，with38patientsineachgroup.Thepatients inthecontrolgroupreceivedlaparoscopiccommonbileductexploration（LCBDE）combinedwithLC，andthoseintheobservation groupreceivedERCP/ESTcombinedwithLC.Thetwogroupswerecomparedintermsofsurgicalblodlos，postoperativerecoverytime，lengthofhospitalstay，hospitalcosts，liverfunction，andtheincidencerateofcomplications. Results Therewasno significantdiferenceintotalstoneclearanceratebetwenthetwogroups （χ2=0.214，P>0.05） .Comparedwiththecontrolgroup， theobservationgrouphadasignificantlyshorterpostoperativerecoverytime，asignificantlylowerblodlos，asignificantlylonger lengthofhospitalstay，andsignificantlyhigherhospitalcosts （t=3.208-13.397，P<0.05） ）.Therewerenosignificantdiferences intheactivitiesofalanineaminotransferaseandaspartateaminotransferasebetwenthetwogroupsbeforesurgery （P>0.05 ），and bothgroupshadsignificantreductionsinthesetwoindicatorsonday3aftersurgery，buttheobservationgrouphadsignificantly loweractivitiesthanthecontrolgroup （t=3.589-13.928，P<0.05） ）.Therewasnosignificantdiferenceintheoveralincidence rateofpostoperativecomplicationsbetwentheobservationgroupandthecontrolgroup （21.0% v s18.4%;χ2=0.083，P>0.05） ）.Conclusion ERCP/ESTcombinedwithLChasarapidrecoveryofliverfunctionaftersurgeryandissuitableforpatientswithpor generalconditionswhorequiresrapidreliefofobstruction，witha certaindegre ofsafety.

[Keywords] choledocholithiasis;cholecystolithiasis;cholangitis;cholangiopancreatography，endoscopicretrograde;sphincterotomy，transduodenal;cholecystectomy，laparoscopic;treatmentoutcome

胆石症是指胆道系统（包括胆囊或胆管内）发生结石的疾病[1]。（剩余6375字）