摘要
目的探讨腹腔镜联合胆道镜经胆囊管治疗胆食结石合并胆总管结石的应用价值。方法 2009年5月至2016年5月腹腔镜下经胆囊管治疗胆囊结石合并胆总管结石39例,横行剪开胆囊管1/2~2/3周径或胆囊管汇入部微切开,置入胆道镜,完成胆道探查后一期缝合切开处或置"T"管引流。结果 39例均完成腹腔镜联合胆道镜经胆囊管探查取石术。31例Hem-o-lok夹闭胆囊管,5例T管引流,39例全部取净胆总管结石;手术时间55~150min,平均92min,术中出血20~60mL,平均18mL,术后1例胆瘘,腹腔引流7d痊愈。结论腹腔镜联合胆道镜经胆囊管胆道探查取石创伤小、恢复快、具有很好的临床应用价值。
Objective To study the value of laparoscopic common bile duct exploration for cholecystolithiasis and choledocholithiasis through the cystic duct.Methods From May 2009 to May 2016, laparoscopic common bile duct exploration through the cystic duct was performed in 39 cases cholecystolithiasis and choledocholithiasis. The distal part of the cystic duct was tranversed cut open by 1/2-1/3 circumference or the cystic duct into the micro-incision to introduce the choledochoscope. Afterwards the micro-incision and cystic duct was sutured or left open to place the T-tube. Results Laparoscope combined with choledochoscope common bile duct exploration was performed successfully through the cydtic duct in all the 39 cases, including 31 cases by useing Hem-o-lok clips and 5 cases with T-tube placement. The common bile duct in all stone clearance rate was 100%.The mean operation time, blood loss were 55-150 min（mean, 77 min）, 20-60 mL（mean,18 mL）. One patient developed minor bile leakage postoperatively and recovered after 7 days of conservative treatment. Conclusion Laparoscope combined with choledochoscope through the cydtic duct common bile duct exploration has advantages of minimal invasion and rapid recovery, being a good clinical option.
出处
《中国医药指南》
2017年第28期15-16,共2页
Guide of China Medicine
关键词
腹腔镜
胆道镜
胆总管结石
腹腔镜胆总管探查术
Laparoscope
Choledochoscope
Common bile duct
Laparoscopic common bile duct exploration
