【摘要】 目的 探究腹腔镜胆囊切除术（Laparoscopic Cholecystectomy, LC）+内镜下逆行胰胆管造影术（Endoscopic Retrograde Cholangiopancreatography, ERCP）用于胆囊结石合并肝外胆管结石患者的效果。方法 方便选取2022年6月—2023年6月酒泉市人民医院肝胆科收治的86例胆囊结石合并肝外胆管结石患者为研究对象，按随机数表法分为观察组和对照组，各43例。对照组施以开腹胆囊切除联合胆总管探查取石，观察组施以LC联合ERCP。对比两组手术效果、术后情况、手术成功率和残石率、谷丙转氨酶（Glutamic-pyruvic Transaminase, ALT）、天门冬氨酸氨基转移酶（Aspartate Aminotransferase, AST）水平。结果 与对照组比较，观察组术中出血量较少，手术和住院时间较短，禁食、排气、腹腔引流时间较少，视觉模拟评分法评分较低，差异有统计学意义（P均<0.05）；观察组手术成功率（97.67%）较对照组（81.40%）高，残石率（2.33%）较对照组（18.60%）低，差异有统计学意义（χ~2=4.467,P<0.05）；术后24 h，观察组ALT、AST水平较对照组低，差异有统计学意义（P均<0.05）。结论 LC+ERCP施以胆囊结石合并肝外胆管结石患者能提高手术效果，改善围术期情况，促康复，极大提升手术成功率，增强肝功能。更多还原

【Abstract】 Objective To explore the effect of laparoscopic cholecystectomy(LC)+ endoscopic retrograde pancreatic angiography(ERCP) used in the cases of gallbladder stone with extrahepatic bile duct calculi. Methods A total of 86patients with cholecystolithiasis combined with extrahepatic cholecystolithiasis admitted to the Hepatobiliary Department of Jiuquan People’s Hospital from June 2022 to June 2023 were conveniently selected as the study objects, and were divided into observation group and control group according to random number table method, with 43 cases in each group. The control group was treated with open cholecystectomy combined with common bile duct exploration and stone extraction, and the observation group was treated with LC combined with ERCP. The operative effect, postoperative conditions, operative success rate, residual stone rate, glutamic-pyruvic transaminase(ALT) and aspartate aminotransferase(AST) levels were compared between the two groups. Results Compared with the control group, the observation group had less intraoperative blood loss, shorter operation and hospitalization time, less fasting, exhaust and abdominal drainage time, and lower scores by visual simulation score,the differences were statistically significant (all P<0.05). The success rate of operation in observation group(97.67%) was higher than that in control group(81.40%), and the residual stone rate(2.33%) was lower than that in control group(18.60%), the difference was statistically significant(χ2=4.467, P<0.05). 24 h after operation, ALT and AST levels in observation group were lower than those in control group, and the difference was statistically significant(both P<0.05). Conclusion LC+ERCP can improve the operative effect, improve perioperative conditions, promote rehabilitation, greatly increase the success rate of surgery and enhance liver function in patients with cholecystolithiasis combined with extrahepatic bile duct stones.更多还原