硬性胆道镜保胆取石(息肉)80例报告

目的探讨硬性胆道镜微创保胆取石(息肉)的可行性。方法2006年10月～2007年3月,用Wolf硬性胆道镜行保胆取石(息肉)手术80例。喉罩全身麻醉,迷你腹腔镜直视肋缘下小切口抓取胆囊,胆囊底部小切口,应用Wolf硬性胆道镜进行胆囊探查、取石(息肉),直径>0.5cm的结石,用套石网取出,直径<0.5cm的结石以及泥沙样结石用胆囊泥沙样结石吸取箱取出,取石钳从根部摘除胆囊息肉。应用胆囊泥沙样结石吸取箱设备,用推、挤、压、撕、撑、冲6种手法,发现并清除8例55窝胆囊黏膜下结石,3-0肠线间断缝合胆囊底部切口。结果80例硬镜微创保胆取石(息肉)手术顺利,平均手术时间63min,平均住院4d,均治愈出院,无并发症发生。发现并清除8例55窝胆囊黏膜下结石,最少1例1窝,最多1例30窝,发生率10%。结论硬性胆道镜微创保胆取石术是一项新技术,安全、有效。

Appilition of mini compact nephroscope in ehdecystolithotomy(eholecystopolyptectomy)with gallbladder preserved

Objective] To investigate the feasibility of using mini compact nephroscope in micro invasive ehdecystolithotomy(eholecystopolyptectomy)through endoscope with gallbladder preserved.Methods] 80 cases of micro invasive ehdecystolithotomy(eholecystopolyptectomy)were dealt with WOLF mini compact nephroscope from Oct 2006 to Mar.2007.We caught and cut off the gallbladder with the mini laparoscope under laryngeal mask general anesthesia,explored in it,and then removed the stones and polyps by mini compact nephroscope.We caught the stone with the stone extractor and extract when its diameter was more than 0.5 cm.When it was less than 0.5 cm or muddy stone we used the cholecyst muddy stone suction box.Gallbladder polyps were removed from the root with stone forceps.Cholecyst muddy stone suction box removed the stones by methods such as thrusting,squeezing,stamping,ripping,poling,and dashing,55 cavities of submucosa cholecystolithiasis in 8 patients were found in this report.And we sutured the gallbladder finally.Results] 80 cases treated with the mini compact nephroscope in micro invasive ehdecystolithotomy(eholecystopolyptectomy)through endoscope with gallbladder preserved were successful.The average operation time was 63 minutes,the average hospitalization was 4 d.All of them were curing with no complications.Discovering and clearing 55 cavities of submucosa cholecystolithiasis in 8 patients,at least 1 cavity in a patient,at most 30 cavities in 1 patient,and incidence was 10%.Conclusions] The application of mini compact nephroscope in micro invasive ehdecystolithotomy through endoscope with gallbladder preserved is a new,safe and effective technology.