腹腔镜经胆囊管胆道探查取石术36例报告

目的：探讨腹腔镜经胆囊管治疗胆总管结石的疗效。方法我院2006年6月～2013年10月腹腔镜下经胆囊管治疗胆总管结石36例，分离胆囊管至近胆总管处，Hem-o-lok结扎胆囊管近端，横行剪开胆囊管远端1／2～2／3周径，置入胆道镜。结果手术时间45～110 min，平均77 min；术后住院时间3～5 d，平均4．2 d。均无胆漏，无胆道残余结石发生。36例随访2～24个月，平均15个月，无上腹部疼痛症状，无结石复发。结论腹腔镜经胆囊管胆道探查取石术治疗胆总管结石创伤小、恢复快，具有很好的临床应用价值。

Laparoscopic Transcystic Common Bile Duct Exploration：a Report of 36 Cases

Objective To explore the clinical application of laparoscopic transcystic common bile duct exploration . Methods Clinical data of 36 cases of laparoscopic transcystic common bile duct exploration for common bile duct stones from June 2006 to October 2013 in this hospital were retrospectively analyzed .The cystic duct was seperated adjacent to the common bile duct and ligated proximally by using Hem-o-lok clips.The distal part of the cystic duct was tranversed cut open by 1/2-2/3 circumference to introduce the choledochoscope . Results The operation time was 45-110 min （mean, 77 min）, and the postoperative hospital stay was 3-5 d （mean, 4.2 d）.No bile leakage occurred, and no residual stones of biliary tract was found.All the 36 cases were followed up for 2 -24 months （ mean, 15 months）, without abdominal pain or stone recurrence . Conclusion Laparoscopic transcystic common bile duct exploration has advantages of minimal invasion and rapid recovery , being a good clinical option .