文档介绍：·这是由于课代表水平有限,所以自己又划了一些感觉重要的地方
·这是找不到对应的中/英文或者在该段落中重复出现
·整理的不好的地方请亲们自行修改,感谢亲们的支持,欢迎亲们请我吃饭,祝亲们英语都考个好成绩!
trial of laparoscopic exploration mon bile duct1versus2postoperative endoscopic retrograde cholangiography mon bile duct stones.
Background:The management 1of stones in mon bile duct in the laparoscopic era2 is controversial3. The three major options4 are preoperative5 endoscopic retrograde cholangiography (ERCP), laparoscopic exploration of mon bile duct (LECBD), or postoperative ERCP.
Methods:Between August, 1995, and August, 1997, 471 laparoscopic cholecystectomies were done in our department. In 427 (91%), satisfactory1 preoperative cholangiography was obtained2. In 80 (17%) of these cases there were stones in mon bile duct. 40 patients were randomised to3 LECBD and 40 to postoperative ERCP. If LECBD failed, patients had4 either5 open exploration of mon bile duct or5 postoperative ERCP. If one postoperative ERCP failed6, the procedure was repeated7]until mon bile duct was cleared of stones8 or an endoprosthesis was placed9to prevent stone impaction10. The primary endpoints11 were duct-clearance rates, morbidity12, operating time, and hospital stay. Analyses were by intention to treat.
Findings:Age and sex distribution of patients was similar in the randomised groups. Duct clearance after the first intervention1 was 75% in both groups. By the end of treatment, duct clearance was 100% in the laparoscopic pared with2 93% in the ERCP group. Duration of treatment was a median of 90 min (range 25–310) in the laparoscopic group (including ERCPs for3 failed LECBD) compared with2 105 min (range 60–255) in the postoperative ERCP group (p=, 95% CI for difference -5 to 40). Hospital stay3 was a median of 1 day (range 1–26) in the laparoscopic pared with2 days (range 1–11) in the ERCP group (p=, 95% CI 1–2).
Interpretation:LECBD is as effective as ERCP in clearing mon bile duct of stones. There is a non-significant trend1 to shorter time in