实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (4): 629-632.doi: 10.3969/j.issn.1672-5069.2026.04.038

• 胆石症 • 上一篇    下一篇

同期三镜联合行球囊鼻胆管引流术治疗胆囊结石合并胆总管结石患者疗效研究*

魏平, 冯章东, 牛旭, 孙武青, 韩威   

  1. 101149 北京市 首都医科大学附属北京潞河医院普外科
  • 收稿日期:2025-10-29 出版日期:2026-07-10 发布日期:2026-07-20
  • 通讯作者: 韩威,E-mail:dr-han@vip.sina.com
  • 作者简介:魏平,男,41岁,医学硕士,主治医师。E-mail:lhyyzhaoxin@163.com
  • 基金资助:
    *北京市卫健委科研基金资助项目(编号:2023-0058)

Simultaneous three endoscopic operation in combination with balloon nasobiliary drainage in treatment of patients with gallbladder stones and common bile duct stones

Wei Ping, Feng Zhangdong, Niu Xu, et al   

  1. Department of General Surgery, Luhe Hospital, Affiliated to Capital Medical University, Beijing 101149, China
  • Received:2025-10-29 Online:2026-07-10 Published:2026-07-20

摘要: 目的 探讨同期腹腔镜、胆道镜和十二指肠镜三镜联合行球囊鼻胆管引流术治疗胆囊结石合并胆总管结石患者的疗效。方法 2020年6月~2024年12月我院收治的92例胆囊结石合并胆总管结石患者,其中46例对照组采用腹腔镜下胆囊切除联合胆总管切开取石和T管引流术,另46例观察组采用同期三镜联合行球囊鼻胆管引流术治疗。采用ELISA法检测血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)。结果 观察组手术时间为(78.5±12.3)min,显著长于对照组【(65.2±10.1)min,P<0.05】,而术后首次排气时间为(18.5±3.2)h,显著短于对照组【(24.3±4.1)h,P<0.05】,两组结石清除率为97.8%对95.7%,无显著性差异(P>0.05);术前术后两组肝功能指标和血清炎性反应指标均无显著性差异(P>0.05);术后,两组胆漏、出血、胰腺炎或感染等发生率(6.5%对6.5%)比较,也无显著性差异(P>0.05)。结论 采用同期三镜联合行球囊鼻胆管引流术治疗胆囊结石合并胆总管结石患者可优化手术过程,提高患者舒适度和生活质量,值得临床进一步验证。

关键词: 胆囊结石, 胆总管结石, 腹腔镜, 胆道镜, 十二指肠镜, 球囊鼻胆管引流术, 治疗

Abstract: Objective The aim of this study was to investigate simultaneous three endoscopic (e.g., laparoscope, choledochoscope and duodenoscope) operation in combination with balloon nasobiliary drainage in treatment of patients with gallbladder stones and common bile duct stones. Methods 92 patients with gallbladder stones and common bile duct stones were encountered in our hospital between June 2020 and December 2024, of them, 46 patients in control group received laparoscopic cholecystectomy (LC) and laparoscopic choledocholithotomy with T-tube drainage, and another 46 patients in observation group received simultaneous three endoscopic operations and balloon nasobiliary drainage treatment. Serum C-reactive protein, interleukin-6 and tumor necrosis factor-α levels were detected by ELISA. Results Operation time in the observation group was (78.5±12.3)min,much longer than [(65.2±10.1)min,P<0.05], while postoperative first exhaust time was(18.5±3.2)h,much shorter than [(24.3±4.1)h,P<0.05] in the control group,and stone clearance rates in the two groups were 97.8% vs. 95.7%,not significantly different (P>0.05);pre- or post-operationally, serum liver function tests and cytokine levels didn’t significantly be different between the two groups(P>0.05);post-operationally, incidences of adverse effects, such as bile leakage, bleeding, infection and pancreatitis were not significantly different between the two groups(6.5% vs. 6.5%, P>0.05). Conclusion Simultaneous three endoscopic operations and balloon nasobiliary drainage could optimize surgery protocol, which might improve quality of life in patients with gallbladder stones and common bile duct stones and is worthy of further clinical verification.

Key words: Gallbladder stone, Common bile duct stone, Laparoscope, Choledochoscope, Duodenoscope, Balloon nasobiliary drainage, Therapy