腹腔镜胆道镜联合治疗胆总管结石104例报告

目的探讨腹腔镜、胆道镜联合治疗胆总管结石的手术方法及临床应用价值。方法回顾性总结2006年8月至2010年12月收治的104例胆总管结石患者经腹腔镜胆总管探查术的临床资料。结果 104例患者中94例胆囊结石合并胆总管结石患者接受了腹腔镜胆囊切除＋胆总管探查取石;10例胆囊或胆道手术史的胆总管结石患者接受了腹腔镜胆道探查取石术。手术时间（90±30）min。78例患者（75.0%）未放置T管,全部治愈,无中转开腹;术后早期胆漏发生率6.4%（5/78）,引流3～5d后自愈。26例放置T管患者术后造影3例有残留结石,后经胆道镜取出。结论腹腔镜联合胆道镜胆总管探查治疗胆总管结石手术安全有效。

Laparoscopy combined with choledochoscopy in treating choledocholithiasis: report of 104 cases

Objective To investigate laparoscopic surgery combined with choledochoscopy for the common bile duct.Methods The data of 104 patients with choledocholithiasis who and undergone laparoscopic surgery for the bile duct from August 2006 to December 2010 were analyzed retrospectively.Results In the 104 patients,94 were treated with LC＋LCBDE,and 10 were treated with LCBED.The mean operation time was（90±30） minutes,and 78 patients（75.0%） were cured without use of T-tubes.The operative procedures were successful in all the patients with no intraoperative conversion.Bile leakage rate was 6.4%（5/78） early after operation,but all leaks were cured by drainage within post-operative days 3-5.In 26 patients who underwent T-tube placement,3 were found residue stones after operation;all of whom were cured by choledochoscopy.Conclusions Combined use of laparoscopy and choledochoscopy in treating choledochelithiasis was proved to be effective with a lower morbidity and mortality.It is an ideal choice of therapy for patients with choledocholithiasis