Clinical Study on Duodenoscopy Combined with Choledochoscopy for Gallbladder-preserving and Stone Removal Treatment/YANG Yanyan，LIXiaorong，ZHULiping.//Medical Innovationof China，2025， 22（20）： 016-019

[Abstract] Objective： To evaluate the clinical efect of duodenoscopy combined with choledochoscopy for gallbladder-preserving stone removal inthe treatment ofcommon bileduct stones combined with galbladder stones.Method：A total of 44 patients with common bileductstonescombined with gallladder stones who received treatment inthe Departmentof GastroenterologyatAfiliated Hospital of Gansu Medical College from January 2022 to January 2O24 were randomly divided into two groups，with 22 patients in each group.The control group received endoscopic retrograde cholangiopancreatography （ERCP） + endoscopic sphincterotomy （EST） + endoscopic nasal bile duct drainage （ENBD） + laparoscopic cholecystectomy （LC） treatment， while the observation group received duodenoscopy combined with choledochoscope for gallbladder-preserving stone removal.The complications， postoperative recovery indicators，quality of life，and serum related indicators of each group were compared and analyzed.Result：The incidence of complications in the observation group was lower than that in the control group，and various surgical and serological indicators werebeterthan those in the control group，with statistically significant differences（ P lt;0.05）.The postoperative quality of life scores of the observation group were higher than those of the control group，the differences were statistically significant （ P lt;0.05）.Conclusion： The overall effect of treating patients with commonbile duct stones combined with gallbladder stones by using duodenoscopy combined with choledochoscope forgallladder-preserving stone removal is relatively good.The postoperative recovery is fast， the risk of complications is low，and patients can return to normal life as soon as possible.

[Keywords] DuodenoscopyCholedochoscopeGallbladder-preserving stone removal

First-author's address：Department of Gastroenterology，Affiliated Hospital of Gansu Medical College，Pingliang 7440oo，China

胆囊结石作为一种常见的消化系统疾病，其发病率在全球范围内呈上升趋势，发病与多种因素有关，如饮食习惯、遗传因素、肥胖等，患者常表现为右上腹疼痛、恶心、呕吐等症状，给患者带来了诸多痛苦和健康隐患[]。临床关于结石疾病的治疗手段有很多，而且多年来，医学领域一直在不断探索更为安全、有效的治疗方法。传统的胆囊切除术虽然在一定程度上能够解决胆囊结石问题，但同时也带来了胆囊功能丧失等一系列后果。随着医疗技术的不断进步，微创手术逐渐成为主流，十二指肠镜联合胆道镜保胆取石方法应运而生，这些新的治疗手段在为患者提供更多选择的同时，也引发了关于治疗效果、安全性等的深入思考[。鉴于此，选定于甘肃医学院附属医院就诊的胆总管结石合并胆囊结石患者为主体，旨在通过对不同治疗方法进行全面对比，进一步分析十二指肠镜联合胆道镜的临床治疗价值，为医学治疗决策提供科学依据。

1资料与方法

1.1一般资料

选择2022年1月一2024年1月本院消化内科收治的44例胆总管结石合并胆囊结石患者。纳入标准：经腹部CT、彩超和胆管成像（MRCP）等检查确诊；满足上述手术指征；符合文献[3]《肝胆管结石病诊断治疗指南》的相关标准；ASA分级I＼～II级；年龄 gt;20 岁；术前检查提示胆囊壁无明显水肿、增厚，胆囊管无迁曲冗长，胆囊管内嵌顿结石较小，胆囊结石较小（最大直径 ⩽5mm ）；临床资料无缺失。排除标准：近期有其他手术史；合并胆管狭窄或肝内胆管结石；……