关键词: 老年, 胆总管结石, 胆囊结石, 内镜下乳头括约肌切开术, 腹腔镜胆总管探查取石术, 腹腔镜胆囊切除术

Abstract:

Objective To explore the choice and efficacy of treatment for elderly patients with choledocholithiasis combined with cholecystolithiasis. Method The elderly patients with cholecystolithiasis and choledocholithiasis diagnosed in Pingdu People's Hospital hospital from February 2017 to November 2019 were selected and randomly divided into the observation group (n=34) and the control group (n=32). The observation group was treated with step-by-step endoscopic sphincteropapillotomy(EST) combined with laparoscopic cholecystectomy (LC), and the control group was treated with LC combined with laparoscopic common bile duct exploration T-tube choledochotomy (LCBDE). The total operation time, indwelling time of drainage tube after operation, intraoperative bleeding, postoperative hospital stay, conversion from laparoscopy to laparotomy, stone removal rate, and postoperative complications (including fever, bile leakage, pancreatitis) were compared between the two groups. Result The total operation time, drainage tube retention time, and postoperative hospitalization time of patients in the observation group were shorter than those in the control group, with less intraoperative bleeding and lower conversion rate to laparotomy in the observation group (P ＜ 0.05). There was no significant difference between the two groups in stone removal rate and postoperative complication rate (P ＞ 0.05). Conclusion Both EST+LC and LC+LCBDE can effectively treat the elderly patients with cholecystolithiasis and choledocholithiasis, but in county hospitals with both technology and equipment, EST+LC is more beneficial for elderly patients with choledocholithiasis and choledocholithiasis.

Key words: Elderly, Choledocholithiasis, Gallstone, Endoscopic sphincteropapillotomy, Laparoscopic common bile duct exploration T-tube choledochotomy, Laparoscopic cholecystectomy