胆道术后腹腔镜下胆总管探查25例分析

目的探讨胆道术后腹腔镜下胆总管探查临床应用价值。方法对我院1996年10月～2008年2月胆道术后腹腔镜下胆总管探查25例进行回顾性总结分析。结果本组25例，手术时间55～155min，平均96min；术中出血50～120ml，平均65ml；住院时间4d～9d，平均6d。术后并发胆漏2例，经过引流后分别于术后第4d，第6d引流管内无胆汁后拔管，痊愈出院，无死亡病例发生。术后胆道残余结石7例，均在2m后进行胆道镜取石，一次性取出。所有病人均获得随访，随访时间3m～5y，平均2．5y，1例肝内胆管结石复发，复发时间为术后4y，其他病人恢复良好，无结石复发，无胆道狭窄。结论胆道术后应用腹腔镜进行胆总管探查技术创伤小、恢复快，是一种安全、可行的方法，值得腹腔镜外科专家推广。

THE LAPAROSCOPIC COMMCON BILE DUCT EXPLORATION FOR REOPERATON OF BILIARY SYSTEM: A CLINICAL ANALYSIS OF 25 CASES

Objective To investigate the clinical effect of the laparoscopic common bile duct exploration for reoperation of biliary system. Methods 25 cases with laparoscopic common bile duct exploration for reoperation of biliary system were retrospectively analyzed from October, 1996 till February, 2008. Results The mean operative time of 25 cases was 96 rain （55 - 155 min）. The mean blood loss was 65ml（50 - 120 ml）. The mean length of stay was 6 days（4 -9 d）. 2 cases suffered from bile leakage after operation, they were cured by draining , drainage tube was extubated at 4 days and 6 clays respective after operation when drainage tube had no liquid. All patiens were cured and had no death. 7 cases suffered from retained calculus, retained calculus were removed only one time by choledochoscope after 2 months. All pafiens were followed-up, the mean time was 2.5 years （3months -5years ） , one case of calculus of intrahepatic duc was recrudescence after 4 years, the other patiens were very well, the calculus was not recrudescence and the stenochoria of biliary tract was not occurred. Conclusions The laparoscopic common bile duct exploration for reoperation of biliary system is minimally invasive, safe and feasible , this technique should be extended by laparoscopic experts