目的比较腹腔镜胆囊切除联合胆总管探查术（LC＋LCBDE）与内镜下Oddi括约肌切开取石联合腹腔镜胆囊切除术（EST＋LC）治疗胆囊结石合并肝外胆管结石的临床疗效。 方法回顾性分析45例行LC＋LCBDE及60例行EST＋LC患者的临床资料，观察2组在单次结石清除率、中转手术率、手术并发症、住院时间等指标方面的效果。 结果2组患者的基线资料相近，无手术死亡病例；2组术后并发症发生情况的差异无统计学意义（P＞0.05）；LC＋LCBDE组单次治疗成功率高于EST＋LC组，而住院时间及中转手术率则短于或低于EST＋LC组（P＜0.05）。 结论LC＋LCBDE是治疗胆囊结石合并肝外胆管结石患者安全有效的方法。
ObjectiveTo explore the effects of CO2 pneumoperitoneum and posture on circulation function for elderly patients with rectal cancer during laparoscopic operation. MethodsRetrospective analysis of clinical data of 48 elderly patients with rectal cancer was performed, and the data included the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), cardiac output (CO), cardiac index (CI), central venous pressure (CVP), pH, partial pressure of oxygen (PaO2), and partial pressure of carbon dioxide (PaCO2) at before anesthesia (T1), after anesthesia (T2), after the establishment of CO2 pneumoperitoneum (T3), placement in trendelenburg position after operation (T4), 30 minutes after operation (T5), 60 minutes after operation (T6), 90 minutes after operation (T7), and 120 minutes after operation (T8). ResultsThe levels of HR, SBP, DBP, MAP, CO, CI, pH, PaO2, and PaCO2 at 8 time points didn't statistically differed with each other (P>0.05), but the levels of CVP at T7 and T8 time point were significantly higher than those of T1 and T2 time point (P<0.05). ConclusionsDuring laparoscopic operation period for the elderly patients with rectal cancer, the CVP will gradually increase. If the preoperative assessment and administration are done well during peri-operation period, laparoscopic operation is safe for the elderly patients with rectal cancer.