关键词: 胆囊结石, 肝外胆管结石, 腹腔镜胆囊切除术, 内镜下逆行胰胆管造影术, 治疗

Abstract: Objective The aim of this study was to summarize the clinical efficacy of laparoscopic cholecystectomy (LC) and endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of patients with gallbladder and extrahepatic bile duct stones. Methods 142 patients with gallbladder and extrahepatic bile duct stones were encountered in our hospital between March 2018 and March 2022, and 71 patients in control group were treated with traditional open laparotomy, and another 71 patients in observation group were treated with ERCP and thereafter LC. Serum C-reactive protein (CRP) level was detected by immunoturbidimetry, and serum procalcitonin (PCT) level was detected by solid-phase immunochromatography. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were assayed by double-antibody one-step sandwich method. Results The surgical time, intraoperative blood loss, the visual analogue scale score and hospital stay in the observation group were (92.3±8.7)min, (47.9±5.2)mL, (3.8±0.4) and (5.2±2.3)d, significantly shorter or less than [(116.4±10.2)min, (76.5±6.4)mL, (4.1±0.5) and (7.1±2.6) d, respectively, P<0.05], while the medical cost was (34000.0±4000.0) yuan, much higher than [(27000.0±3000.0) yuan,P<0.05] in the control; three days after operation, serum CRP, IL-6 and TNF-α levels in the observation were (48.4±2.9)mg/L, (9.7±1.2)ng/L and (1.3±0.2)ng/L, significantly lower than [(61.7±3.1)mg/L, (14.3±1.6)ng/L and (2.4±0.2)ng/L, respectively, P<0.05] in the control; the incidence of post-operationally complications, such as acute pancreatitis, bleeding, infection and bile leak, in the observation was 11.3%, much lower than 23.9%(P<0.05) in the control group. Conclusion The application of ERCP and thereafter LC combination in the treatment of patients with gallbladder and extrahepatic bile duct stones could effectively improve the surgical-related indicators, ensure the stone clearance and promote the postoperative recovery, which might be related to a relatively low systemic inflammatory reactions.

Key words: Gallbladder stones, Extrahepatic bile duct stones, Laparoscopic cholecystectomy, Endoscopic retrograde cholangiopancreatography, Therapy