腹腔镜联合十二指肠镜治疗胆囊结石合并肝外胆管结石75例分析

目的探讨腹腔镜十二指肠镜二镜联合治疗胆石症的治疗效果,减少开腹手术和提高治愈率。方法回顾性分析2006年1月一2010年12月采用腹腔镜联合十二指肠镜治疗胆囊结石合并肝外胆管结石75例的临床资料。结果 75例患者均治愈出院,住院时间为9-18d。在腹腔镜行胆囊切除手术中,无1例中转开腹手术,无术后出血,胆漏腹腔感染等并发症发生。在十二指肠镜下行肝外胆管结石手术中,所有病例均获得成功。术后发生胆管炎6例及急性胰腺炎5例,均经保守治疗治愈。出院时经B超,CT或鼻胆引流造影显示无结石残留。结论二镜联合治疗胆石症具创伤小、结石除净率高、并发症少等优点,该方法对胆囊结石合并肝外胆管结石安全有效。

Laparoscopy combined with duodenoscopy in the treatment of cholecystolithiasis associated with calculi of extrahepatic duct(Analysis of 75 cases)

Objective To explore the therapeutic effects on laparoscopy combined with duodenoscopy for the treatment of cholecystolithiasis associated with calculi of extrahepatic duct.Methods From January 2006 to December 2010,the clinical data of 75 cases with cholecystolithiasis associated with calculi of extrahepatic duct undergoing laparoscopy eombined with duodenoscopy were analyzed retrospectively.Results Seventy five cases were cured to discharge from hospital.The hospitalization time was in 9～18 days.In the laparoscopic procedure,none case was transffered to open abdominal surgery and no bleeding,biliary leakage and abdominal infection were found after operation.Duodenoscopic procedure was performed successfully in all cases and postoperative cholangitis,acute pancreatitis were in 6 and 5 cases respectively.All cases of operative complications were cured by canservation treatment.Conclusion Laparoscopy combined with duodenoscopy possesses less trauma,higher calculous clearance rate and fewcomplication.It is safe and effectve method for treating cholecystolithiasis associated with calculi of extrahepatic duct.