腹腔镜经胆囊管胆总管探查取石术的临床应用

目的总结腹腔镜经胆囊管胆总管探查取石术的经验,探讨该手术方法。方法回顾分析2002年1至2005年3月,我科应用腹腔镜经胆囊管胆总管探查取石术治疗49例胆囊结石或胆总管结石。结果全组49例患者中47例获成功,l例胆道肿瘤合并结石及l例胆总管结石合并左肝管狭窄中转开腹,全组无发生胆瘘及无死亡病例;术后随访42例,随访时间2～24个月,随访的42例中无胆总管结石复发及狭窄者。结论腹腔镜经胆囊管胆总管探查取石术如能正确掌握适应证,是一种创伤小、康复快,安全,并发症少的手术方法。

Clinical application of laparoscopic common bile duct exploration through cystic duct

Objective To summarize the experience of laparoscopic common bile duct exploration through cystic duct and explore the operative method and it's advantages and disadvantages.Methods From January 2002 to March 2005,49 cases with cholecystolith or choledocholith received laparoscopic exploration of common bile duct and choledocholithotomy through cystic duct were analyzed retrospectively.Results Among 49 cases,47 cases were operated successfully.2cases were converted to open abdominal surgery,because of tumor of biliary tract associated with stone and choledocholith associated with stenosis of left hepatic duct.No biliary fistula was happened and nobody died in this group.Postoperative follow-up was gotten in 42 cases.Follow-up time was from 2 to 24 months.No recurrence of choledocholith and stenosis of biliary tract were found during follow-up period.Conclusion If the operation indication can grasp correctly,the laparoscopic common bile duct exploration and choledocholithotomy through cystic duct are an ideal operative method.It has many advantages,such as less trauma,quick recovery,safe and less complications.