腹腔镜胆道探查术治疗胆石症的临床应用体会

目的探讨腹腔镜胆道探查术治疗胆石症的技术关键。方法该组共23例，胆总管纵向切开1．5-2．0cm用取石钳、胆道镜等取石。结石取净者作胆总管一期缝合，不能肯定取净者作T管引流。术中胆管外径≥1.0cm。术前无明确结石者作术中胆道造影；术前置鼻胆管的胆源性胰腺炎作延期胆道探查术。结果胆管造影7例，结石阳性2例；胆总管一期缝合8例；T管引流15例，结石残留2例，经术后胆道镜取净残石。结论腹腔镜胆道探查是一种安全、可靠的治疗胆石症的方法。

Clinical application of laparoscopic bile duct exploration in treatment of choledocholithiasis

Objective]To study the clicniclal application of laparscopic bile duct exploration in treatment of choledocholithtasis. Of 23 cases, the patients in which gallstones were removed succesfully by forceps and choledochoscopy were operated with primary suture, while the other cases in which the residual stones were presented were placed T tube drainage.If external diameter of bile duct is over 1.0 cm, intraoperative cholangiography was performed.Bile duct exploration was delayed in patients with acute gallstone pancreatitis. These patients were placed nosobiliary drainage. Of 7 cases in which intraoperative cholangiography was performed, gallstones were found in 2 cases. 8 cases were operated with phmary Suttire. T tubes were placed in 15 cases. The residual stones were removed by choledochoscopy in 2 cases postoperatively. Conclusions] Laparoscopic bile duct exploration is a safe and reliable method in treatment of choledocholithiasis.