摘要
目的探讨腹腔镜胆囊切除术中十二指肠镜下乳头切开取石术治疗胆囊结石继发胆总管结石的手术方法和适应征。方法腹腔镜下行胆囊切除术,经胆囊管残端插入输尿管导管或斑马导丝至十二指肠腔,经口插入十二指肠镜至十二指肠乳头,针式刀或弓式刀在输尿管导管或斑马导丝指引下对乳头施行切开术,用十二指肠镜取石网或球囊取石。结果施行术中十二指肠镜下乳头切开取石术121例,109例乳头切开取石成功,7例乳头切开成功,5例中转为其他术式。术后轻症胰腺炎7例。无肠穿孔、胆管穿孔、大出血、重症胰腺炎等严重并发症,无死亡。结论只要选择合适的患者,腹腔镜胆囊切除术中十二指肠镜下乳头切开取石术是可行、有效和安全的。
Objective To explore the operation methods and indications of duodenoscopic papillotomy during the course of laparoscopic cholecystectomy（LEST）. Methods To accomplish choleeysteetomy, through ureterie catheter and zebra guidewire of cholecystic duct remnant into the common bile duct and duodenum,through duodenoscopy via oral into the papillary of duode- num, were used to cut through the stenosis of papillary for electro-knife by pin-head-like and arch-like to track along the ureterie catheter and zebra guidewire,to clear the stones of the common bile duct with the reticulation and the balloon of duodenoscopy. Results LEST was successful in 116 out of 121 cases. Five cases were shifted to other operation. Seven patients was a slight pancreatitis. No cases had perforation of intestine and bile duct, bleeding, severe pancreatitis and death. Conclusion If patients are suitable, LEST is safe and effective in the hands of skilled endoscopiests.
出处
《四川医学》
CAS
2009年第12期1925-1927,共3页
Sichuan Medical Journal
关键词
腹腔镜
十二指肠镜
乳头切开术
胆结石
therapeutic laparoscopy
duodenoscopy
papillotomy
cholelithiasis
