摘要
目的探讨腹腔镜胆总管切开取石术放置'T'管的处理方法以及改进措施,提高患者实际临床治疗效果。方法选取某院肝胆外科2009年6月~2014年6月行腹腔镜胆总管切开取石(Laparoscopiccommonbileductexploration,LCBDE)、置T管以治疗肝外或肝外合并肝内胆总管结石患者140例为研究对象,胆总管切开取石,进行一期缝合或置T管。结果胆总管切开取石一期缝合25例(17.9%),置T管115例(82.1%)。手术中结石取尽86例(61.4%)、术后胆道镜取石54例(38.6%)。置T管患者术后5~8w经过T管胆道造影确诊无结石残留后摘除T管,140例患者术后跟踪回访3~60个月,并无复发现象。结论患者实施腹腔镜胆总管切开取石术放置T管进行治疗,T管拔管时间以及T管胆道造影无残留结石后拔管时间为术后5~8w时间,拔管后闭管2w时间可以在很大程度上提高患者实际临床治疗效果。
Objective To investigate the cut of laparoscopic common bile duct stone extraction for placing'T'tube processing method as wel as improvement measures,improve the actual clinical therapeutic ef ect.Methods Selecting a hospital liver and gal bladder surgery in June 2012 to June 2014 slit ing line of Laparoscopic common bile duct lithotomy(Laparoscopic comm on bile duct exploration,LCBDE),T tube in the treatment of extrahepatic or extrahepatic combined liver,140 cases of bladder stones patients as the research object,cut take bravery manager stone,for a period of suture and T tube.Results The common bile duct incision lithotomy stitching issue 25 cases(17.9%),T tube 115 cases(82.1%).Stones in the operation in 86 cases(61.4%),postoperative choledochoscope lithotomy 54 cases(38.6%).Buy from 5 weeks to eight weeks postoperatively in patients with T tube after T tube biliary imaging diagnosis of stone residue after removal of T tube,140 cases of patients with postoperative fol ow up to 60 months,3 months and no recur ence.Conclusion The patients with the implementation of laparoscopic common bile duct incision nephrolithotomy treatment placed T tube,T tube decannulation time and T tube biliary imaging without residual calculi after extubation time for 5 weeks to eight weeks postoperatively,closed tube 2 weeks after extubation time can largely improve the actual clinical therapeutic ef ect.
作者
王明利
WANG Ming-li(Meishan City Geriatrics Hospital,Meishan 620010,Sichuan,China)
关键词
腹腔镜
胆总管切开取石术
T管
处理方法
改进措施
Laparoscopic
Cut stone extraction for bravery manager
T tube
Processing methods
Improvement measures
