Abstract：【Objective】 To investigate the effectiveness of combined staged laparoscopic surgery in treating patients with acute common bile duct and gallbladder stones.【Methods】 Sixty patients admitted to two hospitals with acute common bile duct and gallbladder stones were randomly divided into an observation group and a control group, with 30 patients in each. The control group underwent simultaneous total laparoscopic surgery [laparoscopic common bile duct exploration (LCBDE) + laparoscopic cholecystectomy (LC)], while the observation group underwent combined staged laparoscopic surgery [endoscopic sphincterotomy (EST) + endoscopic retrograde cholangiopancreatography (ERCP) + LC]. Surgical related indicators, pre- and post-operative intestinal flora levels, post-operative complications and prognosis were compared between the two groups.【Results】The operation time, post-operative time to first flatus, and post-operative hospital stay in the observation group were shorter than those in the control group (P<0.05). The intraoperative blood loss was also less in the observation group (P<0.05). Compared to the control group, the levels of E. coli and Enterococcus were lower, while the level of Bifidobacterium was higher in the observation group post-operatively (P<0.05). The rates of post-operative fever and acute pancreatitis were 3.33% and 6.67%, respectively, in the observation group, which were lower than 26.67% and 23.33% in the control group (P<0.05). There were no significant differences in the rates of post-operative bleeding, wound infection, and peritoneal infection between the groups (P>0.05).【Conclusion】 Combined staged laparoscopic surgery not only shortens the surgery time, post-operative time to first flatus, and post-operative hospital stay, reduces intraoperative blood loss, but also improves intestinal flora levels in patients with acute common bile duct and gallbladder stones. Moreover, it offers higher safety and better long-term prognosis.
刘云涵, 王超, 王林林, 段铭杰. 三镜联合分期手术治疗急性胆总管结石合并胆囊结石的效果[J]. 医学临床研究, 2024, 41(7): 1001-1004.
LIU Yunhan, WANG Chao, WANG Linlin, et al. The Effectiveness of Combined Staged Laparoscopic Surgery in the Treatment of Acute Common Bile Duct and Gallbladder Stones. JOURNAL OF CLINICAL RESEARCH, 2024, 41(7): 1001-1004.
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2024, Vol. 41 
