目的 观察内镜逆行胰胆管造影(ERCP)+内镜十二指肠乳头括约肌切开术(EST)与腹腔镜胆总管切开探查术(LCBDE)+胆总管一期缝合术(CBDE)联合腹腔镜胆囊切除术(LC)治疗老年胆囊结石合并胆总管结石的疗效.方法 回顾性分析我院自2014年1月～2017年9月间收治的胆囊结石合并胆总管结石患者的临床资料,按随机、平衡、对照原则分别筛选ERCP+ EST+ LC治疗患者40例作为观察组,另选取LCBDE+ CBDE+ LC治疗患者40例作为对照组,对比两组手术时间、术中出血、术中开腹比例及结石残余比例及术后肝功能指标,并统计并发症发生率及术后通气通便时间、住院天数、住院费用.结果 两组手术时间、术中出血、术中中断开腹比例、结石残余比例、术后肝功能指标、并发症发生率、术后通气通便时间、住院天数、住院费用等指标比较差异均无统计学意义.结论ERCP +EST或LCBDE+ CBDE联合LC治疗胆囊结石合并胆总管结石均能取得满意疗效,但在临床选择上还需个体化原则使患者受益最大化.%Objective To observe the curative effect of endoscopic retrograde cholangiopancreatography (ERCP) + endoscopic sphincterotomy (EST) and laparoscopic common bile duct exploration (LCBDE) + common bile duct suture (CBDE) combined with laparoscopic cholecystectomy (LC) in the treatment of elderly patients with gallstone and choledocholithiasis.Methods The clinical data of patients with gallstone and choledocholithiasis who were treated in the hospital from January 2014 to September 2017 were retrospectively analyzed.40 patients treated by ERCP + EST + LC were included in the observation group and another 40 patients treated by LCBDE + CBDE + LC were included in the control group.The operative time,intraoperative blood loss,ratio of open operation,rate of residual stones and postoperative liver function indexes were compared between the two groups.The incidence of complications,postoperative ventilation and laxative time,hospital stay and hospitalization expenses were statistically analyzed.Results There was no significant difference between the two groups in operative time,intraoperative blood loss,ratio of open operation,rate of residual stones,postoperative liver function indexes,the incidence of complications,postoperative ventilation and laxative time,hospital stay or hospitalization expenses.Conclusion ERCP + EST or LCBDE + CBDE combined with LC can achieve satisfying results in treating gallstone with choledocholithiasis.The appropriate operation should be chosen according to the patient's actual condition.
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