腹腔镜胆总管探查术32例临床分析

目的:探讨腹腔镜胆总管切开取石和"T"管引流术的实用性和优越性。方法:用腹腔镜联合纤维胆道镜施行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)+胆总管切开取石+"T"管引流术。结果:32例手术均获成功。手术时间60~90min。术后2~3d肠功能恢复,可下床活动,并进流质饮食。术后5~7d出院。术后12d来院复诊,试行夹管并行"T"管造影,2例发现残余小结石1枚,直径0.2~0.3cm,术后2个月经窦道取出,造影检查无异常。结论:选择性为部分胆总管结石患者施行腹腔镜胆总管切开取石+"T"管引流术临床效果好,较开腹手术、经胆囊管腹腔镜胆总管探查术及LC+内镜括约肌切开术更具优越性和实用性。

Clinical analysis of laparoscopic common bile duct exploration for 32 patients

Objective:To investigate the practicability and superiority of laparoscopic choledocholithotomy T-tube drainage(LCTD).Methods:Thirty-two cases underwent laparoscopic cholecystectomy(LC)+LCTD with laparoscopy combined with fibrocholedochoscopy were analyzed restrospectively.Results:Operations for all 32 patients were successful,and the operative time was 60-90min.The time of intestinal function recovery was 2-3 days after operation.Meanwhile,patients could walk freely and take fluid food.Postoperative hospital stay was 5-7 days.Patients returned visit 12d after operation,underwent occlusion of tube and T-tube visualization.One little residual calculus was found in 2 cases,the diameter of calculus was 0.2-0.3cm,which was removed 2 months later through sinus tract.Contrast examination was normal.Conclusions:For some choledocholith patients,the LCTD has a satisfied clinical effect which is better and more practicable than laparotomy,trans-cystic duct laparoscopic common bile duct exploration+LC,and endoscopic sphincterotomy.