腹腔镜胆囊切除术治疗胆囊管结石嵌顿32例报告

目的 总结腹腔镜胆囊切除术时处理胆囊管结石嵌顿的经验。方法 对32例胆囊管结石嵌顿病例,其中12例术前先行MRCP而后行腹腔镜下胆囊管切开取石,20例术中行胆囊管切开取石而后术中胆道造影,再完成LC。如术中胆道造影发现合并胆总管结石,则予以中转开腹手术。结果 全组病例LC成功25例,7例中转手术,术后住院时间LC为3～5d,中转开腹手术为7～2ld,均痊愈出院,无严重并发症。结论 大部分胆囊管结石嵌顿病人可用胆囊管切开取石方法完成LC,并结合术前MRCP或术中胆道造影,可避免胆总管结石的遗漏。

Teratment of stone impacted at cystic duct during laparoscopic cholecystectomy: a report 32 cases

Objective To summarize our experience in the management of ston es impacted at cystic duct during laparoscopic cholecystectomy.Methods32cases with stones impacted at cystic duct,12cases with stones impacted at cystic duct were ex-amined by MRCP before operation,then cystic duct was incised to remove stone s under laparoscope;20cases with stones impacted at cystic duct cystic duct w as incised to remove stones,then intraopera-tion cholangiography was p erformed,so they can receive LC.If stones were found in common bile duct,they wo uld be converted to open opera tion.Results Among them,25cases were cured by LC, 7cases were converted to open operation.The hos-pitalized period ofter LC ranged from3to5days.The period of converting open operation ranged from7to21days.All w ere cured without serious complication.Conclusion Nearly all cases with stones impacted at cystic duct can receive LC by removing impacted stones through incis ing the cys-tic duct and MRCP before operation or intraopera-tive cholangiograph y,it can avoid omission of stones in common bile duct.