腹腔镜下经胆囊管胆总管取石术的临床应用

目的 :本文报告了在腹腔镜下应用胆道镜经胆囊管取石治疗 8例胆囊结石合并胆管结石 ;方法 :采用腹腔镜和胆道镜联合应用在腹腔镜胆囊切除基础上经胆囊管导入胆道镜用取石网取出胆管内结石 ;结果 :本组 8例患者 ,除 1例因结石位于肝总管内和 1例多发结石未能取出外 ,其它 6例均获得成功。手术平均时间 2h33min ,术后住院时间 4～ 1 7d ,平均住院9d ,无并发症发生 ;结论 :该方法具有创伤轻、痛苦小、住院时间短等特点 ,适合于胆管结石合并胆管内单发结石的治疗。但对于多发结石或结石 >1 0mm以上 ,以及位于肝侧胆管内结石治疗较为困难。

The Clinical Application of Cholelithotomy with Biliary Tract Scope under Abdominoscope

Objective:To discuss the method of cholelithotomy with biliary tract scope under abdominoscope after treatment of 8 cases of cholecystolithiasis and choledocholith.Methods:the method of abdominoscope combined with biliary tract-scope was taken to perform cholelithotomy via cystic duct based on cholecystectomy.Results:6 cases were obtained success except 1 case of gallstone in common hepatic duct and 1 case of multiple gallstone.The average operative time was 2h and 33 min and average hospitalized days were 9d (4～17 d after operation).There was no complication happened.Conclusions:This method could have advantage of less injury and pain with short hospitalized time.It might be available for single gallstone but difficult for multiple gallstones or more than 10mm in diameter and common hepatic stone.