腹腔镜胆总管探查术693例报告

目的总结运用腹腔镜胆总管探查术的治疗经验。方法回顾性分析 1992年 3月至2 0 0 3年 3月运用腹腔镜胆总管探查术对 6 93例患者进行治疗的经验及效果。结果即时缝合的 391例中 ,373例治疗获得成功 ;T管引流的 30 2例中 2 72例获得成功。扩张膜状狭窄 74例中效果满意 6 8例 ,恶性狭窄 15例中 11例支架引流获得成功 ,既往有开腹或腹腔镜胆囊胆管手术史者 4 2例中再次手术成功 36例。中转开腹 7例 ,胆漏 2 4例 ,术后残石内镜未取净 11例 ,死亡 4例。结论腹腔镜胆总管探查术对于有较高内镜和腹腔镜技术者是可行、有效和安全的。

Laparoscopic common bile duct exploration:a report of 693 cases

ObjectiveTo summarize the experience on laparoscopic common bile duct exploration(LCDE). MethodsFrom Mar. 1992 to Mar. 2003, there were 693 cases undergoing LCDE. ResultsThe procedure was successful in 373 out of 391 cases with primary closure of duct incision and 272 out of 302 cases of T tube placement. Membrane stenosis dilation was successful in 68 out of 74 cases. Eleven out of 15 cases of malignant stenosis was successfully treated by biliary endoprosthesis and stent without bile leakage. Seven cases were shifted to open CBD exploration. Bile leakage was cured conservatively in 24 cases. Endoscopy failed to totally remove residual stones in 11 cases. Four cases died postoperatively. Conclusion LCDE was safe and effective in the hands of skilled endoscopists.