目的:探讨腹腔镜胆囊切除术(LC)与内镜十二指肠乳头括约肌切开术(EST)联合应用治疗胆囊结石合并胆总管结石的临床效果。方法:回顾性分析我院开展的LC联合EST治疗胆囊结石合并胆总管结石76例,其中56例先行EST后行LC,20例先行LC后行ERCP/EST。结果:本组全部治愈,先行EST组56例,3例并发胰腺炎,3例出血,2例再发胆总管结石,先行LC组20例行EST11例,6例取石后未做括约肌切开,3例结石自行掉入肠道,1例出现胆道感染,1例胰腺炎,无出血及穿孔。结论:内镜治疗胆囊结石继发胆总管结石具有创伤小、效果好、并发症少、恢复快的的特点;先作EST可解除胆道梗阻、减轻炎症,并为LC创造条件,选择性先行LC后可减轻创伤,甚至不必做EST。
Objective To explore the effects of bile from patients with cholecystolithiasis on the growth of human gallbladder carcinoma cells GBC-SD and the potential correlation between cholecystolithiasis and gallbladder carcinoma. Methods Cholecystolithiasis bile (CB) and normal bile (NB) specimens were used for this study. The proliferative effects of bile were measured by methabenzthiazuron (MTT) assay and cell cycle and apoptosis were analyzed by flow cytometry. Results CB can significantly promote the proliferation of GBC-SD cells, GBC-SD proliferative index increased significantly after treated with 1% CB for 48 h （P＜0.05）.The Sphase fraction of CB 〔（49.26±8.07）%〕 increased remarkably (P＜0.05) compared with that of NB 〔（25.54±6.57）%〕, and the CB percentage of G0/G1 phase 〔（40.59±9.12）%〕 decreased remarkably (P＜0.05) compared with NB 〔(60.64±13.42）〕%. Conclusion CB can promote the proliferation of human gallbladder carcinoma GBC-SD cells.