腹腔镜、胆道镜联合微创保胆取石术的临床应用(附30例报告)

目的探讨腹腔镜、胆道镜联合微创保胆取石术的临床应用价值。方法回顾分析我院采用腹腔镜、胆道镜联合微创保胆取石术治疗30例胆囊功能正常的胆囊结石患者的临床资料。结果 30例均成功取尽结石,结石直径介于1cm～2.5cm,平均手术时间50min,出血10～30ml,平均住院5.5d。手术后无出血、胆漏及心肺等并发症发生。术后随访1～29个月,中位随访时间9个月;1复发1例,复发率3.3%。结论腹腔镜、胆道镜联合微创保胆取石术保持了胆道的完整性及胆囊功能,具有安全性高、操作简单、患者创伤小、康复快等优点,结石复发率低,适合胆囊功能正常的胆囊结石病人。

Clinical application of laparoscope combined with choledochoscope for removing calculi and conserving-gallbladder (A report of 30 cases)

Objective To explore the value of new mini-invasive surgery for removal of calculus and preservation of gallbladder with laparoscope and choledochoscope. Methods The clinical data of 30 patients with cholecystolithiasis who underwent mini-invasive surgery for removal of calculus and preservation of gallbladder was analyzed retrospectively. Results All stones were removed successfully. The diameter of stone ranged from 1cm to 2.5cm. The average operative time was 50min， blood loss was 10min -30m，and mean hospitali stay was 4d. No postoperative bleeding，bile leakage，cardiopulmonary compalication occurred. All the patients were followed up for 1mon to 29 month, and the mediate follow-up was 9 months. Only one case recurred during the follow-up, and the recurrent rate was 3.3%. Conclusions: The new mini-invasive surgery for removal of calculus and preservation of gallbladder is safe and feasible. It keeps the integrity of biliary tract and the function of gallbladder, and has the advantages of simplicity, small wound, slight pain and quick recovery. The recurrent rate was relatively low.