총수담관 담석을 동반한 담낭담석 환자에 대한 저 침습성 치료

Abstract

In order to evaluate the effects of laparoscopic cholecystectomy(LC) following endoscopic sphincterotomy for cholelithiasis with choledocholithiasis, a clinical study of twenty patients who successfully underwent LC with EST was performed. Eight hundred seven patients underwent LC from Jan. 1992 to Dec. 1994 at Department of General Surgery of Severance Hospital, and 102(12.6%) cases of these were indications of endoscopic retrograde cholangiopancreatography (ERCP). Among the patients 'who were found to have common bile duct stones by ERCP, twenty successfully underwent EST with LC. Indication for ERCP and the accuracy of these indications were as follows: jaundice(15 patients, 53.3%), abnormal liver function test(41, 36.6), CBD stones found by ultrasonogram(20, 90), CBD dilatations found by ultrasonogram(39, 25.6), gall stone pancreatitis(14, 21.4%). Average duration from EST to LC was 4.1dyas(minimum 1day, maximum 8 days). Average duration from LC to discharge was 4.6days(minimum 1 day, maximum 9days). Average duration of total admission was 10.7 days(minimum 5 days, maximum 18 days). Complication rate of EST and LC was 10.0% and 0.0%, respectively. The result of LC with EST is good in admission duration, patient's satisfaction, cosmesis, postop. morbidity & mortality and recurrence rate. LC with EST is a good, minimally invasive surgical treatment modality for patients with cholelithiasis combined with choledocholithiasis. However a longer follow-up period will be needed to better assess long term results.