腹腔镜胆囊切除术后胆总管残留结石的转归

目的:研究腹腔镜胆囊切除术(laparoscop ic cholecystectomy,LC)后胆总管残留结石的处理及转归。方法:回顾分析我院1992年4月至2006年6月15 000余例LC术后28例胆总管残留结石的原因、治疗及转归。结果:LC术后28例胆总管残留结石中结石自行排出3例,ERCP确诊25例,25例通过EST成功取石,其中1例为术后胆漏并发胆管结石。结论:通过加强术前检查、术中仔细操作和术后积极处理,可减少LC术后胆总管残留结石及其他严重并发症的发生。

Resolution of residual common bile duct calculi after laparoscopic cholecystectomy

Objective:To explore resolution and treatment of residual common bile duct calculi after laparoscopic cholecystectomy(LC).Methods:During April 1992 and June 2006,15 000 consecutive LC were performed,residual common bile duct calculi were found in 28(0.18%) cases.Therapy and resolution of residual common bile duct calculi were analyzed retrospectively.Results:The residual common bile duct calculi discharged spontaneously in three cases.Twenty-five cases were confirmed and resolved by ERCP.One of these patients was diagnosised as biliary fistula and residual common bile duct calculi among the 25 cases which calculi were removed by EST.Conclusions:It is important to reinforce preoperative examination,careful operation and postoperative management in order to reduce the iuvident of residual common bile duct calculi and other serious diseases.