腹腔镜胆囊切除术主动中转开腹联合胆道镜免置“T”管的临床价值

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术中主动中转开腹并免置"T"管的临床意义。方法:回顾分析117例LC主动中转开腹患者的临床资料,中转后使用胆道镜经胆囊管或胆囊管胆总管联合切开探查取石术。结果:根据主动中转的评分方法,6~7分为相对中转指征,≥8分为绝对中转指征。阳性发现63例(53.8%),其中胆总管输入性结石58例,右肝管结石2例,肝门部结石1例,胆囊管结石嵌顿2例,均未放置"T"管,术后无结石残留和胆道狭窄。结论:LC术中适时主动中转开腹手术,联合使用胆道镜检查或取石,不放置"T"管,具有重要的临床意义。

Clinical value of active conversion to open surgery combined with choledochoscopy without T-tube drainage during laparoscopic cholecystectomy

Objective:To explore the clinical significance of active conversion to open surgery combined with choledochoscopy without T-tube drainage during laparoscopic cholecystectomy(LC).Methods:Clinical data of 117 cases undergoing active conversion into open surgery during LC was collected and retrospectively analyzed.Choledochoscopic exploration and cholelithotomy were performed via cystic duct or cystic duct and common bile duct.Results:According to the scoring system of active conversion to open surgery,relativ...