对比分析内镜下逆行胰胆管造影术（ERCP）序贯手术与一期手术治疗肝囊型包虫（CE）破入胆道的临床疗效。

选取2016年1月至2021年8月28例肝CE破入胆道患者，根据术式不同分为观察组（ERCP序贯手术，n=13）与对照组（一期手术，n=15）。对比两组炎症指标、肝功能、原发病灶处理方式、手术指标、复发率及并发症。采用SPSS 25.0统计软件进行数据分析。计量资料先行正态性检验，符合正态分布者以（±s）表示，组间比较采用独立样本t检验；不符合正态分布者以中位数（四分位数）表示，采用非参数秩和检验。计数资料组间比较采用χ²检验或确切概率法。以P<0.05为差异有统计学意义。

治疗后两组炎症及肝功能指标均改善（P<0.05），两组间炎症及肝功指标比较差异无统计学意义（P>0.05）；观察组手术时间、术中出血量及术后拔管时间均短于对照组（P<0.05）；观察组复发率（7.7%）较对照组（20.0%）低，但差异无统计学意义（P>0.05）；两组患者并发症发生率差异无统计学意义（P>0.05），但观察组严重程度较轻。

ERCP序贯手术的临床疗效显著，可有效控制胆道感染，解除梗阻，改善患者症状。使病情严重、无法耐受手术治疗的患者能够接受手术并能有效降低手术风险，加速患者康复，值得临床推广。

To compare and analyze the clinical efficacy of ERCP sequential surgery versus one-stage surgery in the treatment of hepatic cystic echinococcosis (CE) with biliary rupture.

A total of 28 patients with hepatic CE complicated by biliary rupture, treated from January 2016 to August 2021, were selected. According to the different surgical methods, they were divided into the observation group (ERCP sequential surgery, n=13) and the control group (one-stage surgery, n=15). Inflammatory indicators, liver function, primary lesion management methods, surgical indicators, recurrence rate, and complications were compared between the two groups. Statistical software SPSS 25.0 was used for data analysis. Normality test was first performed on the measurement data: those conforming to normal distribution were expressed as (±s), and independent samples t test was used for inter-group comparison; those not conforming to normal distribution were expressed as median (interquartile range) and analyzed by non-parametric rank-sum test. Chi-square test or exact probability method was used for inter-group comparison of count data. P<0.05 was considered statistically significant.

After treatment, the inflammatory indicators and liver function indicators of both groups improved (P<0.05), but there was no statistically significant difference in these indicators between the two groups (P>0.05). The operation time, intraoperative blood loss, and postoperative extubation time in the observation group were shorter than those in the control group (P<0.05). The recurrence rate in the observation group (7.7%) was lower than that in the control group (20.0%), but the difference was not statistically significant (P>0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05), but the severity of complications in the observation group was milder.

ERCP sequential surgery has significant clinical efficacy. It can effectively control biliary infection, relieve obstruction, and improve patients’ symptoms. It enables patients with severe conditions who cannot tolerate surgery to undergo treatment, effectively reduces surgical risks, and accelerates patient recovery, which is worthy of clinical promotion.