腹腔镜胆囊切除联合内镜逆行胆管取石治疗胆囊结石合并继发胆总管结石的临床研究

目的探讨腹腔镜胆囊切除术（LC）与内镜逆行胆管取石联合应用治疗胆囊结石合并胆总管结石的临床效果,探讨胆囊结石合并继发胆总管结石的微创外科治疗策略。方法选取20例患者术前经CT和MRCP检查确诊为胆囊结石合并继发胆总管结石,胆总管结石1～4枚,大小为0.4～1.0cm。全组患者先行LC手术,术后1～3天患者肛门排气后行内镜逆行胆管取石,在B超引导下使用取石网篮取干净总胆管结石,取石后常规放置ENBD管,行鼻胆管造影明确胆总管无结石残留。结果全组20例患者均获得成功,术后造影均无结石残留。结论LC与内镜逆行胆管取石联合应用治疗胆囊结石合并胆总管结石较传统开放手术有明显的优势,治疗效果确切,创伤性少。

Laparoscopic cholecystectomy combined with endoscopic retrograde bile duct stone treatment gallstone with secondary choledocholithiasis Clinical Research

Objective Laparoscopic cholecystectomy （LC） and endoscopic retrograde bile duct stone removal in treatment of gallstones combined effect of choledocholithiasis explore gallstone with secondary choledocholithiasis minimally invasive surgical treatment strategies. Methods 20 patients by preoperative CT and MRCP diagnosed as cholelithiasis with secondary common bile duct stones, common bile duct stones 1-4, a size of 0.4-1.0cm. Whole group of patients with LC before surgery, after 1-3 days later in patients with anal exhaust endoscopic retrograde bile duct stones, in B-guided use of clean stone basket from bile duct stones, stones placed after the conventional ENBD tubes, nasal cholangiography common bile duct stones without a clear residue. Results 20 patients werc to be successful, postoperative angiography had no residual stones. Conclusions LC and endoscopic retrograde bile duct stone removal in treatment of cholelithiasis with choledocholithiasis combined more traditional open surgery has obvious advantages, the exact treatment, less traumatic.