目的：探讨经腹腔镜胆囊切除胆总管切开探查取石术（LCBDE）治疗老年胆囊疾病合并胆总管结石患者的临床效果及安全性。方法：回顾性分析采用LCBDE 治疗（LCBDE 组）与内镜下Oddi 括约肌切开取石术（EST）联合腹腔镜胆囊切除术（LC）治疗（LC-EST 组）的老年（≥ 60 岁）胆囊疾病合并胆总管结石患者各60 例的临床资料。结果：两组患者术前一般资料具有可比性。LCBDE 组患者的手术时间、住院时间及手术并发症发生率均明显的低于LC-EST 组（均P<0.05）；术中出血量、术后肛门排气时间、手术成功率、一次性手术成功率、中转开腹率、一次性结石清除率两组间差异均无统计学意义（均P>0.05）。结论：LCBDE 治疗老年胆囊疾病合并胆总管结石与LC 联合EST 手术效果相当，但具有手术时间短、术后恢复快、并发症率低的优点。
Clinical efficacy of laparoscopic cholecystectomy and common bile duct exploration for elderly patients with gallbladder disease and concomitant choledocholithiasis
Objective: To investigate the clinical effect and safety of laparoscopic cholecystectomy and common bile duct exploration (LCBDE) in the treatment of elderly patients with gallbladder disease and concomitant common bile duct stones. Methods: The clinical data of elderly patients (≥60 years of age) with gallbladder disease and common bile duct stones undergoing LCBDE treatment (LCBDE group, n=60) or endoscopic sphincterotomy (EST) plus laparoscopic cholecystectomy (LC) (LC-EST group, n=60) were retrospectively analyzed. Results: The preoperative data between the two groups of patients were comparable. The operative time, length of postoperative hospital stay and incidence of operative complications in LCBDE group were significantly decreased compared with LC-EST group (all P<0.05), while there was no significant difference between the two groups with regard to intraoperative blood loss, time to first postoperative flatus, and the rate of surgical success, open conversion and one-session stone clearance (all P>0.05). Conclusion: LCEST has similar therapeutic effect with LC plus EST in treatment of elderly patients with gallbladder disease and common bile duct stones, but it also has the advantages of short operative time, quick recovery and low incidence of complications.