■胆总管结石,胆石症的常见并发症,会带来重大风险,包括胆管炎和胰腺炎。存在各种治疗方法,包括单阶段和两阶段技术,最近的文献表明,单阶段方法在结果和成本效益方面具有优势。这项研究评估了可行性,功效,与先前采用的两阶段方法相比,单期腹腔镜胆囊切除术联合术中内镜逆行胰胆管造影术(LCiERCP)的安全性和安全性。
对COVID-19大流行(2020-2022年)期间接受单阶段LC+iERCP治疗胆囊胆总管结石的患者进行了回顾性分析。人口统计数据,术前评估,术中参数,收集术后结局,并与接受两阶段方法(LC+术前ERCP)的历史对照组进行比较.同时比较两组患者的住院费用。
■共纳入190名患者,105人接受单级LC+iERCP。单级入路在没有胆囊管插管的情况下成功完成,没有转换为开放手术。手术时间与两阶段方法相当,住院期间,单阶段组的费用明显较低。两组并发症发生率相似。
■单级LC+iERCP似乎是可行的,有效,和治疗胆囊胆总管结石的安全方法,在减少住院时间方面提供潜在的好处,或职业时间,以及与两阶段方法相比的成本。将这种方法纳入临床实践值得考虑,除非存在无法克服的后勤挑战或缺乏内镜专业知识来治疗具有挑战性的紧急情况。
UNASSIGNED: Choledocholithiasis, a common complication of gallstone disease, poses significant risks including cholangitis and pancreatitis. Various treatment approaches exist, including single-stage and two-stage techniques, with recent literature suggesting advantages of the single-stage approach in terms of outcomes and cost-effectiveness. This study evaluates the feasibility, efficacy, and safety of single-stage laparoscopic cholecystectomy combined with intraoperative endoscopic retrograde cholangiopancreatography (LC + iERCP) compared to the previously adopted two-stage approach.
UNASSIGNED: A retrospective analysis was conducted on patients undergoing single-stage LC + iERCP for cholecysto-choledocholithiasis during the COVID-19 pandemic (2020-2022). Data on demographics, preoperative assessments, intraoperative parameters, and postoperative outcomes were collected and compared with an historical control group undergoing the two-stage approach (LC + preopERCP). Hospitalization costs were also compared between the two groups.
UNASSIGNED: A total of 190 patients were included, with 105 undergoing single-stage LC + iERCP. The single-stage approach demonstrated successful completion without cystic duct cannulation, with no conversions to open surgery. Operative time was comparable to the two-stage approach, while hospital stay, and costs were significantly lower in the single-stage group. Complication rates were similar between the groups.
UNASSIGNED: Single-stage LC + iERCP appears to be a feasible, effective, and safe approach for treating cholecysto-choledocholithiasis, offering potential benefits in terms of reduced hospital stay, OR occupation time, and costs compared to the two-stage approach. Integration of this approach into clinical practice warrants consideration, unless there are logistical challenges that cannot be overcome or lack of endoscopic expertise also for treating challenging urgent cases.