缝针穿刺切开胆管法在腹腔镜胆道探查术中的应用

目的：探讨在腹腔镜胆道探查术（laparoscopic common duct exploration, LCDE）中应用缝针穿刺切开胆管法的有效性和安全性。方法：回顾性分析腹腔镜胆道探查手术中应用缝针穿刺切开胆管者75例临床资料。结果：所有患者均采用此法成功切开及探查胆总管，无邻近脏器损伤，无胆瘘及术后出血，无死亡病例；其中腹腔镜中转开腹2例，中转开腹原因1例为胆总管十二指肠内瘘，1例胆总管下段“铸型”结石嵌顿胆道镜无法取出。术后所有患者获4个月至2年随访，均未见胆道狭窄。结论：缝针穿刺切开胆管法是一种在腹腔镜下简单、有效和安全的解剖及切开胆总管的方法。

Application of suture needle puncture and discission of bile duct in laparoscopic common duct exploration

ObjectiveTo evaluate the effect and safety of suture needle puncture and discission of bile duct in laparoscopic common duct exploration(LCDE).MethodsThe clinical data of 75 cases who underwent LCDE with suture needle puncture and discission of bile duct in our department during the past 2 years were analyzed retrospectively. ResultsLCDE was successfully performed in all the 75 cases. No patient had complications, such as injury to adjacent organs, bile leakage or postoperative bleeding,and there were no death. Two cases were converted to open surgery because of internal duodenal and common bile duct fistula in one case, and in another, because of cast-like stone impaction that could not be removed by choledoscope.There was no bile duct stenosis during follow-up of 4 months to 2 years. ConclusionsThe technique of suture needle puncture and discission of bile duct is a simple,effective and safe method for laparoscopic common duct exploration.