摘要
目的 探讨胃毕Ⅱ式术后肝内外胆管结石的腹腔镜及胆道镜治疗.方法 对78例胃毕Ⅱ式术后的患者进行腹腔镜胆囊切除32例,其中胆囊切除＋胆总管切开取石＋胆总管一期缝合12例;胆囊切除＋胆总管切开取石＋T管引流22例;胆囊切除＋胆总管切开取石T管引流＋胆总管十二指肠吻合术6例;胆总管切开取石T管引流＋左肝外叶切除6例.结果 除4例中转开腹外,74例获成功.内镜及腹腔镜术治疗无严重并发症.手术时间为90～240（平均135）min,住院天数4～12（平均9.3）d,术中出血50～400（平均95）ml.随访14～22个月,平均19.4个月,无结石复发.结论 胃毕Ⅱ式术后肝内外胆管结石者施行腹腔镜及胆道镜治疗成功率较高,具有微创、住院时间短、恢复快等优点.
Objective To study laparoscopic management of bile duct stones in patients with a prior Billroth-Ⅱ subtotal gastrectomy. Methods Laparoscopy and choledochoscopy were used in 78 patients with bile duct stones in patients with a previous Billroth-Ⅱ gastrectomy. Thirty-two cases received laparoscopic cholecystectomy, 12 received laparoscopic cholecystectomy, choledocholithotomy with primary choledochorraphy, 22 received laparoscopic cholecystectomy, choledocholithotomy with T- tube choledochostomy, 6 received laparoscopic cholecystomy, choledocholithotomy with choledochostomy and choledochoduodenostomy, 6 received common bile duct exploration with T tube drainage and left lateral hepatectomy, Results Laparoscopy and choledochoscopy were successfully performed in 74 patients, 4 were converted to open surgery. There were no severe complications in patients receiving laparoscopy and choledochoscpey, The operative time was 90 - 240 min（ average 135 min）and blood loss was 50 - 400 ml （average 95 ml ）. All patients were discharged 3 - 10 days after the operation. There were no stone recurrence during a follow up of 14 months to 22 months. Conclusions Laparoscopy and choledochoscopy could be successfully used to treat bile duct stones in patients with a history of Billroth- Ⅱ procedure.
出处
《中华普通外科杂志》
CSCD
北大核心
2007年第1期52-54,共3页
Chinese Journal of General Surgery
关键词
胆结石
胃切除术
腹腔镜
胆道镜
Cholelithiasis
Gastrectomy
Laparoscopes
Choledochoscopy
