关键词: 胆囊结石, 肝外胆管结石, 胆道镜经胆囊管胆道探查取石术, 胆总管切开取石术, 治疗

Abstract: Objective The aim of this study was to compare efficacy of laparoscopic transcystic common bile duct exploration (LTCBDE) andlaparoscopic common bile duct exploration (LCBDE) in dealing with patients with gallbladder stones (GS) and extrahepatic bile duct stones(EBDS). Methods A total of 168 patients with GS and EBDS were enrolled in our hospital between January 2022 and January 2024, and we assigned them to LCBDE in 123 cases in control groupand to LTCBDE in 45 cases in observation group. Serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) levels were detected by ELISA, and blood biochemical parameters were routinely assayed. Results Operation time, intra-operational bleeding, anal exhaust time, post-operationalhospital stay and medical cost in the observation group were(104.4±34.2)min,(29.9±11.2)ml, (22.3±10.1)h, (6.5±2.9)d and (14000±600)yuan, all significantly shorter or less tan [(149.9±37.4)min, (43.6±16.3)ml, (28.4±9.6)h, (9.2±2.4)d and (18000±700)yuan, respectively, P＜0.05] in the control; total stone clearance was obtained in the two groups; three days after operation, serum TNF-α and IL-6 levels in the observation group were(32.5±5.9)ng/L and (25.4±7.1)pg/L, both significantly lower than [(40.3±6.8)ng/L and (35.6±6.4)pg/L, respectively, P＜0.05] in the control; post-operationally, incidences of biliary leakage, biliary tract infection, abdominalinfection, biliary tract hemorrhage and acute pancreatitis in the observation were 0.0%, 2.2%, 2.2%, 0.0% and 0.0%, all not significantly different compared to 2.4%, 0.0%, 4.1%, 1.6%and 2.4% in the control group (P＞0.05). Conclusion Both LCBDE and LTCBDE have good efficacy for stone clearance in patients with GS and EBDS, and we recommend LTCBDE for good postoperative recovery and less economic costs.

Key words: Gallbladder stone, Extrahepatic bile duct stone, Laparoscopic transcystic common bile duct exploration, Laparoscopic common bile duct exploration, Therapy