目的：探讨腹腔镜联合内镜治疗胆囊结石合并肝外胆管结石的临床效果。方法选取本院2012年5月~2015年2月收治的124例胆囊结石合并肝外胆管结石患者作为研究对象，随机分为实验组和对照组。对照组采取开腹手术切除胆囊和去除结石，实验组采取腹腔镜胆囊切除（LC）联合内镜括约肌切开术（EST）取石。比较两组的手术时间、术后排气时间、禁食时间、住院时间、术中出血量、手术成功率、并发症发生率以及结石复发率。结果实验组的手术时间、术后排气时间、禁食时间以及住院时间显著短于对照组，术中出血量显著少于对照组，差异有统计学意义（P<0.05）。两组的手术成功率比较，差异无统计学意义（P>0.05）。实验组的并发症发生率和复发率显著低于对照组，差异有统计学意义（P<0.05）。结论 LC联合EST取石术治疗胆囊结石合并肝外胆管结石效果显著，能减少患者术中出血，加快术后恢复，降低并发症和术后结石复发率，安全可行。%Objective To explore the clinical effect of laparoscopy (LC) combined with endoscopy in the treatment of gallstone complicating with extrahepatic bile duct stone. Methods 124 patients with gallstone complicating with extra-hepatic bile duct stone from May 2012 to February 2015 in our hospital were selected and randomly divided into the experimental group and the control group.The control group was given laparotomy to remove stone,the experimental group was given LC combined with endoscopic sphincherotomy (EST) to remove stone.The operation time,postoperative exhaust time,fasting time,hospitalization time,intraoperative amount of bleeding,surgical success rate,the incidence rate of complication and recurrence rate of stone in two groups was compared respectively. Results The operation time,post-operative exhaust time,fasting time and hospitalization time in the experimental group was shorter than that in the con-trol group,the intraoperative amount of bleeding in the experimental group was less than that in the control group,with singificant difference (P<0.05).There was no significant difference in success rate of surgery in two groups (P>0.05).The incidence rate of complication and recurrence rate in the experimental group was lower than that in the control group, with singificant difference (P<0.05). Conclusion The effect of LC combined with EST in the treatment of gallbladder stone with extrahepatic bile duct stones is remarkable,which can reduce intraoperative blood loss,accelerate postopera-tive recovery,reduce the incidence rate ofcomplication and postoperative recurrence rate,it is safe and feasible.
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