经腹腔镜胆道镜胆总管探查及取石术的临床应用

目的评价腹腔镜下胆总管探查取石术的临床疗效。方法收集并分析我院近两年腹腔镜下胆管探查治疗的53例结石性胆囊炎并胆管结石或扩张病例的资料。结果经胆囊管探查胆管5例,直接切开胆管探查48例。术后18例发生胆瘘,无切口感染,39例一期缝合病人无胆管残余结石及胆管狭窄发生。结论根据病人的情况选择不同的手术入路,腹腔镜胆道探查术治疗结石性胆囊炎合并胆总管结石是安全可行的。

Clinical application of laparoscopic common bile duct exploration

Objective To Evaluate the clinical effects of laparoscopic common bile duct exploration.Methods The clinical data of 53 patients undergoing laparoscopic common bile duct exploration because of calculus cholecystitis combined with choledocholithiasis or dilatation during the recent two years were collected and analyzed retrospectively.Results All cases had gallstones,including 50 cases of choledocholithiasis,3 cases of choledochectasia without stone.The preoperative diagnosis depended mainly on B-ultrasonography and/or ERCP,MRCP.Twenty-eight patients had jaundice and the remaining 25 patients no jaundice.Five patients were subjected to transcystic common bile duct exploration and 48 direct common bile duct exploration.Bile leakage after operation occurred in 18 cases.No incision infection and no post-operative bile duct stenosis and remanent stone occurred in primary suture cases.Conclusion Surgical approach was chosen according to patients' condition.Laparoscopic common bile duct exploration for calculus cholecystitis combined with choledocholithiasis was safe and effective.