腹腔镜胆道镜联合一期缝合治疗胆总管结石的临床探讨(附16例报告)

目的:探讨联合应用腹腔镜、胆道镜治疗胆总管结石和一期缝合术的临床经验。方法:搜集2006年3月-2009年3月间我院实施腹腔镜胆总管探查一期缝合术16例,总结其手术时间、住院时间、手术并发症,对手术效果进行分析。结果:手术成功16例(100%),手术时间60~150min,住院时间7~20d,发生胆漏1例(6.2%)经腹腔引流治愈,残余结石1例(6.2%)经术后十二指肠镜取石治愈。14例随访6~48个月,平均18个月,无胆漏、胆管狭窄、胆道出血发生。结论:严格掌握手术适应证,选择合适的病例,腹腔镜下胆总管探查一期缝合安全、有效、可行。

The Appropriate Treatment of Extraction of Bile Duct Stones with the Operation of Laparoscopic Common Bile Duct Exploration and Primary Suture in 16 Cases

Objective：To report our clinical experience on laparoscopic common bile duct exploration and primary suture in the treatment of extra-hepatic bile duct stones.Methods：The clinical data of 16 paients from March 2006 to March 2009 undergoing this precedure were collected,and sum up operative time,in hospital days,operative complications,and analysis operative efficacy.Results：All 16 cases were operated successfully with laparoscopic cholecystectomy.The operative time was between 60150min and in hospital days were between 720d.Biliary leakage was observed in 1 case（6.2%） after the operation,and was cured by intra-abdominal drainage.1case（6.2%）had residual stones and was cured by a second duodenoscopic surgery.14 of the cases achieved a 6 to 48 months follow-up（mean,18 months）,during the period,no patient developed biliary leak,and stenosis or hemorrhage of the common bile duct.Conclusion：Laparoscopic common bile duct exploration and primary suture is safe and effective.