摘要
目的评价ERCP联合腹腔镜下硬性胆道镜保胆手术治疗胆囊结石合并胆总管结石的临床效果,探讨胆石症的微创外科治疗策略。方法2007年1月-2009年5月,笔者对广州市番禺区第二人民医院39例胆囊结石合并胆总管结石患者先进行内镜下胰胆管造影术(ERCP)治疗,取石后均放置鼻胆管引流(ENBD),然后再进行腹腔镜下硬性胆道镜保胆手术。术后2天行ENBD管造影,确认无结石后拔除ENBD管。结果39例病例均为胆囊结石合并胆总管结石,所有患者均行EST。经取石网篮或球囊导管一次取石成功,术后均放置ENBD管引流,后3天进行腹腔镜下硬性胆道镜保胆取石术。本组39例新式内镜微创保胆取石手术顺利,平均手术时间63min,腹腔镜下硬性胆道镜保胆手术后均无并发症,ENBD导管造影无胆总管残余结石,住院时间4～10天,平均7天。结论ERCP联合腹腔镜下硬性胆道镜保胆手术治疗胆囊合并胆总管结石是安全、彻底、可行的有效方法,即能彻底清除胆囊及胆总管的结石,又能保留胆囊及胆囊的功能,是一种值得推荐的手术方式。
Objective Evaluate the curative effects of the treatment for the cholecystolithiasis with calculus of bile duct by the endoscopic cholangiopancreatography （ERCP） combined with rigid choledochoscope under the laparoscopic.And explore the strategy for the treatment of cholelithiasis with minimally invasive surgical.Methods During the time January 2007 to May 2009, 39 cases of patients with cholecystolithiasis with calculus of bileduct in our hospital were first underwent the treatment by the ERCP, after the calculus removed, all were placed naso-biliary drainage （ENBD）, and then the surgery were done by the rigid choledochoscope under the laparoscopic.ENBD angiography were done two days after the surgery, confirmed after the removal of and removed the ENBD tube when the affirmation of no stones. Results All 39 cases of patients were underwent EST.And stones were removed succesfully on the first time by basket or balloon catheter, ENBD tube drainage were placed for 3 days after laparoscopic.39 cases of this group with new minimally invasive endoscopic surgery were all smooth, and with an average operative time of 63 min, and there were no complication, by the ENBD catheter angiography it were found no residual bile duct stones, the length of stay were 4-10 days and the average were 7 days.Conclnsions ERCP combined with choledochoscope rigid under the laparoscopic is a safe, thorough and effective way possible for the choledocholithiasis with the calculus of bile duct.it can not only remove the calculus, but also retain the function of the gallbladder and the function of the gallbladder.it is a surgical approach to recommend.
出处
《国际医药卫生导报》
2010年第1期27-29,共3页
International Medicine and Health Guidance News
