两种微创术式治疗胆总管结石合并胆囊结石的疗效对比研究OA

Objective:To comparatively analyze the clinical efficacy of laparoscopic common bile duct exploration(LCBDE)combined with laparoscopic cholecystectomy(LC)versus endoscopic retrograde cholangiopancreatography(ERCP)combined with LC in the treatment of choledocholithiasis and cholecystolithiasis.Methods:A total of 104 patients with choledocholithiasis and cholecysto-lithiasis who were admitted from Sep.2023 to Sep.2024 were enrolled.All patients were assigned to the observation group(treated with LCBDE+LC)and the control group(treated with ERCP+LC)by the random number table method,with 52 patients in each group.The surgery-related indicators,incidence of complications,biliary sphincter function,quality of life and short-term recurrence rate were compared between the two groups.Results:There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).The observation group had longer operative time,shorter postoperative anal exhaust time,first ambulation time and hospital stay,as well as lower 24 h postoperative pain score,hospitalization cost and incidence of postoperative complications compared with the control group.At 6 months after surgery,the decreased amplitude of Oddi sphincter pressure and basal common bile duct pres-sure,and the increased amplitude of the sphincter relaxation rate in the observation group were lower than those in the control group,while the increase in generic quality of life inventory score was higher in the observation group.At 12 months after surgery,the stone re-currence rate and reoperation rate of the observation group were lower than those of the control group,and all the differences were statis-tically significant(P<0.05).Conclusions:Compared with ERCP+LC,LCBDE+LC has better clinical efficacy in the treatment of cho-ledocholithiasis and cholecystolithiasis.It can improve the stone clearance rate and patients′ quality of life,shorten hospital stay,re-duce hospitalization costs,lower the incidence of complications and stone recurrence rate,and exert a protective effect on biliary sphincter.