摘要
目的探讨腹腔镜胆囊切除(laparoscopic cholecystectomy,LC)联合乳头括约肌切开术(endo-scopic sphincterotomy,EST)治疗胆囊结石伴胆总管结石的价值。方法回顾性分析164例胆囊结石合并胆总管结石行LC+EST治疗患者的临床资料。结果全组均先行ERCP及EST后再行LC。164例中155例患者共成功取出胆总管结石196枚,取石成功率94.5%,另9例未成功,其中4例胆总管狭窄段大于2cm,另5例结石嵌顿,导丝无法通过。155例EST后6例发生轻度急性胰腺炎,经积极治疗后仍行LC术,LC成功率96.5%,患者平均住院时间(11±4)d。结论ERCP+EST后行LC术是治疗胆囊结石伴胆总管结石的有效方法,有很高的临床应用价值,扩大了胆道微创治疗的范围。
Objective To investigate the value of combined use of laparoscopic cholecystectomy （ LC ） and duodenoscopic procedures in the treatment of gallbladder stones with common bile duct stones. Methods We retrospectively analyzed clinical data of 164 cases of gallbladder stones with common bile duct stones treated with laparoscopic cholecystectomy ＋ endoscopic sphincterotomy （EST）from January 2003 to December 2007. Results All the cases underwent ERCP and endoscopic sphincterotomy （ EST ） followed by LC. In the 164 cases, 196 bile duct stones were extracted from 155cases with a success rate of 94. 5%. The procedures were unsuccessful in 9 cases, and among them, 4 cases had stricture of bile duct more than 2 cm in length, and 5 cases had impacted stones that precluded passage of the guide wire. After EST, 6 of the 155 cases had the complication of mild acute pancreatitis and LC was performed after its treatment. The success rate of LC was 96.5 % and the average hospital stay was （ 11 ± 4 ） d. Conclusions The combined use of EST and ERCP before LC is effective in treatment of gallbladder stones with common bile duct stones, and has broadened the utilization of minimally invasive treatment for bile duct diseases.
出处
《中国普通外科杂志》
CAS
CSCD
2008年第8期739-741,共3页
China Journal of General Surgery
