摘要
目的探讨经胆囊管入路同期三镜（腹腔镜、胆道镜、十二直肠镜）治疗胆囊结石合并细径胆总管结石的手术技巧及临床效果。方法回顾分析2001年2月至2014年11月对141例胆总管内径≤0.8 cm的细径胆总管结石患者进行手术治疗的临床资料。结果 141例病例中,术中直接胆道镜取净结石118例（成功率83.7%）;术中联合十二指肠镜下乳头切开取石术（ECT）取净结石23例（16.3%）。术后胆漏7例,经腹腔引流管引流4~7 d后治愈;术后轻症胰腺炎2例,经保守治疗后痊愈;术后并发症发生率为6.4%。无中转开腹,无肠穿孔、胆管穿孔、大出血、重症胰腺炎等并发症,无死亡。结论只要选择合适的患者,经胆囊管入路同期三镜是治疗细径胆总管结石的新术式,具有创伤小、并发症少、术后康复快、住院时间短、住院费用低等优点,是可行的、有效的和安全的。
Objective To explore the surgical technique and clinical effect of fine diameter transcystic laparoscopy, choledochoscopy, duodenoscopy for common bile duct stones. Methods The clinical data of 141 patients with common bile duct diameter 〈 0.8 cm who undergone operation during Feb. 2001 and Nov. 2014 were retrospectively analyzed. Results Among the 141 cases, 118 patients were completely removed under the choledochoscope （successful rate 83.7%）, 23 patients were completely removed under the combination of endo- scopic cholelithotomy （ECT） （16.3%）. The bile leakage occurred in 7 cases after operation and cured by placing peritoneal drainage for 4-7 d. The slight pancreatitis occurred in 2 cases after operation and cured by conservative treatment. The postoperative complication formation rate was 6.4%. There was no patient converted to laparotomy, no patient with perforations of intestine, bile duct, hemorrhoea and severe pancreatitis, or death. Conclusion As long as the suibate patients are selected, fine diameter laparoscopy, choledochoscope, combined with duodenoscopy is a new surgical treatment to remove the common bile duct stones, becuse it has such advantages, such as fewer trauma, less complication, faster recovery, short postoperative hospital stay, low cost and so on, therefore it is safe, effective and feasible.
出处
《肝胆胰外科杂志》
CAS
2015年第5期358-360,364,共4页
Journal of Hepatopancreatobiliary Surgery
基金
2013年成都市卫生局重大基金课题(2013001)
关键词
腹腔镜
胆道镜
十二指肠镜
细径胆总管结石
laparoscopy
choledochoscopy
duodenoscopy
common bile duct stones with fine diameter
