LC+LCBDE、LC+IO-EST治疗胆囊结石并胆总管 结石的疗效及对患者睡眠质量的影响

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Curative Effect of LC+LCBDE and LC+IO-EST in the Treatment of Gallbladder Stones with Common Bile Duct Stones and Their Impact on Patients’ Postoperative Sleep Quality

LIU Siliang

（Departmentof General Surgery，Jiangning District Second People's Hospital，Nanjing，Jiangsu 21io，China）

AbstractObjective：To explore thecurative efect of laparoscopic cholecystectomy（LC）combinedwith laparoscopic common bileductexploration（LCBDE）versusLCcombined with intraoperativeendoscopic sphincterotomy（IO-EST）inthe treatmentof galbladerstones withcommonbileductstonesandtheiripactonpostoperativeslepqualityof patients.Methods：Atotalof 72 patients with galbladderstones andcommon bileduct stones admited toourhospital between January 2023and January 2025 were enrolled. According to diffrent surgical methods，patients were divided into the observation group（ n=39 ，treated with LC + （204号 LCBDE）and the control group（ n=33 ，treated with LC + IO-EST） . The surgical effect（stone clearance rate，stone recurrence rate）postoperativepaindegree[assessedusingVisualAnalogue Scale（VAS）]，sleepquality[measuredbyPitsburghSleep Quality Idex（PSQI）]，averagedailysleeptimeduring postoperative hospitalization，awakeningfrequencyand incidenceof postoperativecomplicationswerecomparedbetweenthetwo groups.Results：Therewasno significant diferences in stoneclearance rate or recurrence rate between the two groups（ P>0.05 ）. At 3 d and 5 d after surgery，scores of VAS and PSQI in the observation group were lower than those in the control group（ P<0.05， ）. The postoperative average daily sleep time in the observation group was longer than thatin thecontrol group，andawakening frequency was lowerthan that in thecontrol group（ P<0.05） ： There were no significant differences in the incidence of postoperative complications between the two groups（ P>0.05 ） . Conclusion ： The curative effect of LC + LCBDE and LC +IO -EST is comparable in patients with gallbladder stones and common bile duct stones. However，LC + LCBDE has milder postoperative pain，which can guarantee postoperative sleep quality and is beneficial to accelerate postoperative recovery.

KeywordsGalbladder stones combined with common bile ductstones；Laparoscopic cholecystectomy；Laparoscopiccommon bile duct exploration； Intraoperative endoscopic sphincterotomy； Sleep quality

中图分类号：R338.63;R575 文献标识码：A doi：10.3969/j. issn.2095-7130.2025.10.017

胆结石是我国发病率较高的结石疾病，胆囊结石并胆总管结石属于胆结石中常见的结石类型[1]胆囊结石并胆总管结石是诱发急性胰腺炎的危险因素，大体积的结石会阻塞胆管，引发胆管炎、黄疸等炎症反应，对肝脏功能产生影响。（剩余4468字）