摘要
目的:探讨腹腔镜下胆囊切除胆总管切开取石并T管引流术(Laparoscopic cholecystectomy and choledocholithotomy and T tube drainage)的手术方法及术后并发症的防治办法。方法:收治非急性炎症发作期胆总管结石合并胆囊结石患者60例,对手术方法,并发症及疗效进行分析。结果:59例成功施行手术,1例因胆总管下段结石嵌顿中转开腹手术,术后胆瘘1例,经保守治疗痊愈;术后腹腔内少量渗血1例,经止血治疗痊愈;切口感染1例,经清创引流治愈;术后1例发现胆总管内残留结石,术后6周经窦道取石成功。结论:充分术前准备,选择患者合适,及时发现术中损伤,术后及时处理各种并发症,腹腔镜下胆囊切除胆总管切开取石并T管引流术是一种安全、理想的治疗胆系结石的手术方法。
Objectives： To discuss the operation methods of laparoscopic cholecystectomy and choledocholithotomy with T tube drainage,and the treatments of postoperative complications. Methods：By collecting and sifting through 60 cases of non - acute inflammation the patients with choledocholith and cholecystolithiasis during the period from September 2009 to September 2011 in our hospital, and then analyzing the operation methods, complications and curative effect of these cases. Results：All the 60 operations were performed successfully,except one case because of calculi incarceration.There was one case of postoperative biliary fistula,and recovered by conservative therapy;one case of postoperative intraabdominal hemorrhage,then treated by hemostatic therapy;one case of infection of incisional wood after operation, and cured by debridement and drainage;one case of residual cholelith after operation, which was taken out successfully in six weeks after operation. Conclusion： Based on adequate pre -operation preparation, appropriate choice of patients, timely detection of intraoperative injuries,and prompt treatments of all kinds of postoperative complications,laparoscopic cholecystectomy and choledocholithotomy with T - tube drainage is a kind of safe and ideal surgical method to treat biliary stones.
关键词
腹腔镜手术
胆总管结石
胆囊结石
T管引流
并发症
laparoscopic operation
commonbile duct stones in gallbladder stone T tubedrainage
complications
