腹腔镜胆总管探查术的临床应用

目的:总结腹腔镜胆总管切开探查取石术(laparoscopic common bile duct exploration,LCBDE)的临床价值及手术方法。方法:回顾分析2007年3月至2010年8月为85例胆管结石患者行LCBDE的临床资料。术中联合应用胆道镜、输尿管硬镜及气压弹道碎石设备、L形腹腔镜胆道取石钳取石。结果:85例手术均获成功。78例经胆总管探查取石;7例经胆囊管胆总管探查取石。73例使用L形腹腔镜胆道取石钳取结石;12例使用输尿管硬镜气压弹道碎石设备碎石;6例为肝内胆管结石。62例放置T管引流,23例一期缝合胆总管。结论:腹腔镜胆总管探查取石术微创、安全、有效。联合应用胆道镜、输尿管硬镜及气压弹道碎石设备、L形腹腔镜胆道取石钳操作简捷、有效。

Clinical application of laparoscopic common bile duct exploration

Objective:To summarize the experience of laparoscopic common bile duct exploration(LCDE) in our center.Methods:The clinical data of 85 patients with bile duct calculi which performed LCBDE from Mar.2007 to Aug.2010 were analyzed retrospectively.Results:All procedures were performed successfully.78 cases were performed via common bile duct exploration and 7 cases were performed via transcystic common bile duct.L-laparoscopic lithotomy forceps was used in 73 cases;device of pneumatic ballistic lithotripsy was used in 12.T tube was placed in 62 cases,and 23 cases were performed primary suture.Conclusions:Laparoscopic common bile duct exploration is a minimally invasive,safe and effective surgery.Combined with cholangioscopy,ureteroscope and device of pneumatic ballistic lithotripsy,L-laparoscopic lithotomy forceps makes removing the calculi more simple and effective.