摘要
目的探讨腹腔镜再次胆道手术的手术方法。方法回顾性分析从1995年8月至2011年6月经腹腔镜胆总管探查(LCBDE),腹腔镜球囊导管扩张内涵管引流术(LPBD)对胆道术后胆总管复发性结石或残留结石的83例患者腹腔镜再次胆道手术,治疗胆道术后复发或残留结石和胆道狭窄。结果 83例腹腔镜再次胆道手术成功率:开腹胆囊切除术后93.1%(27/29);开腹胆囊切除及胆管探查术后82.4%(14/17);开腹胆囊造瘘术后100%(9/9);开腹胆囊造瘘及胆总管T管引流术后100%(11/11);腹腔镜胆囊切除术后100%(12/12)和腹腔镜胆总管探查术术后100%(5/5)。腹腔镜再次手术获总成功率78例(94.0%),5例中转开腹。术后无并发症发生,无死亡病例。腹腔镜手术时间60～190min,平均120min。结论选择合适患者,腹腔镜再次胆道手术治疗胆管结石和胆管狭窄可以有效预防复发,具创伤小、安全、可行。
Objective To discuss the operative procedures of laparoscopic common bile duct exploration after open biliary operation.Methods From August 1995 to June 2011,the clinical data of 83 patients were analyzed retrospectively.The patients had undergone laparoscopic common bile duct exploration（LCBDE） and laparoscopic palillary ballon dilation endoprosthesis（LPBDE） to extract bile duct stones and treat bile duct stenosis after opening biliary operation.Results The total success rate of laparoscopic reoperation was 94.0%（78/83）,in the 83 patients including 5 patients with conversion to opening CBD exploration.It was 93.1%（27/29） for cholecystectomy,82.4%（14/17） for cholecystectomy and common bile duct exploration,100%（9/9） for cholecyst fistulization,100%（11/11） for cholecyst fistulization and common bile duct exploration T-tube drainage,100%（12/12） for laparoscopic cholecystectomy,and 100（5/5） for laparoscopic common bile duct exploration.There were neither postoperative complications nor deaths.The time for laparoscopic operation was 60-190 minutes,with an average of 120 minutes.Conclusions With the development of laparoscopic technique,LPBDE and LCBDE are applied in reoperation in the biliary tract.Our data indicated that combined operative procedures are practicable,mini-invasive and safe.
出处
《中华普外科手术学杂志（电子版）》
2012年第4期10-12,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
腹腔镜检查
胆道外科手术
再手术
Laparoscopy
Biliary tract surgical procedures
Reoperation
