摘要
目的总结腹腔镜下胆总管探查治疗胆囊结石合并胆总管结石的经验。方法总结2014年1月至2018年5月112例胆囊结石合并胆总管结石患者,均接受腹腔镜胆囊切除胆道探查取石术,胆总管探查的方式分为经胆囊管、经胆囊管汇入部微切开、胆总管切开三种手术方式。结果112例患者均顺利完成腹腔镜下胆囊切除胆总管探查手术,其中14例采用经胆囊管探查;78例采用胆囊管汇入部微切开探查,20采用胆总管切开探查。共有3例术中放置T管,术后行胆道镜治疗;术后9例发生胆漏,保留腹腔引流3 7d后痊愈。结论腹腔镜下胆总管探查首选经胆囊管途径,如胆囊管细或结石较大可行胆囊管汇合部微切开,如胆囊管汇入异常,则需行胆总管前壁切开探查。
Objective To summarize the experience of the laparoscopic common bile duct exploration for choledocholithiasis and cholecystolithiasis.Methods From Jan 2014 to May 2018, laparoscopic common bile duct exploration were successfully completed in 112 cases of choledocholithiasis and cholecystolithiasis.Results Laparoscopic common bile duct exploration was performed successfully in 14 cases through cystic duct, while in 78 cases through the mini-incision at insertion of cystic duct, and in 20 cases through direct incision of common bile duct.In 3 cases T-tube was placed.9 cases developed bile leakage postoperatively and recovered after 3 - 7 days of conservative treatment.Conclusion laparoscopic common bile duct exploration through cystic duct is the first choice of common bile duct exploration followed by mini-incision at insertion of cystic duct.Laparoscopic exploration of common bile duct via choledochotomy was performed when there was abnormal anatomy of cystic duct.
作者
付建柱
计嘉军
栗光明
Fu Jianzhu;Ji Jiajun;Li Guangming(Department of General Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;Department of Hepatobiliary Surgery, Beijing You' an Hospital, Capital Medical University , Beijing 100069, China)
出处
《中华普通外科杂志》
CSCD
北大核心
2019年第5期431-434,共4页
Chinese Journal of General Surgery
关键词
胆囊结石病
胆总管结石
腹腔镜
Cholecystolithiasis
Choledocholithiasis
Laparoscopes
