腹腔镜钬激光治疗高龄胆石病的体会

目的：总结分析腹腔镜、纤维胆道镜联合钬激光治疗高龄胆石病患者的临床经验。方法2011年1月－2013年12月，对38例高龄胆石病患者行腹腔镜、纤维胆道镜联合钬激光碎石治疗。其中胆囊结石9例，原发性胆总管结石7例，胆囊结石并继发性胆总管结石12例，肝内外胆管结石10例。结果38例手术均成功完成，无中转开腹，无死亡。术后并发症7例：切口感染2例，肺部感染3例，胆漏2例，均治愈。术后随访6个月～3年，平均18个月，其中26例＞12个月，无胆道残余结石。结论腹腔镜、纤维胆道镜联合钬激光碎石对于高龄胆石病患者的治疗是安全、有效的、创伤小、并发症少、术后恢复快，拓展了外科手术患者的年龄，扩大了手术人群。

Experience of laparoscopic combined with holmium laser in elderly patients with cholelithiasis

Objective In order to summarize and analyze the clinical treatment experience in elderly patients with cholelithiasis by laparoscopy,choledochoscopy combined with holmium laser lithotripsy. Methods The clinical datum of 38 cases suffered from elderly patients with cholelithiasis were collected from Jan.2011 to Dec.2013 in our hospital,which were undergone laparoscope and choledochoscope combined with holmium laser lithotripsy,included that 9 cases with cholecystolithiasis,7 cases with primary choledocholith,12 cases were cholecystolithiasis with secondary choledocholith,10 cases with calculus of extrahepatic duct.Results Each case was successfully completed,no case die,no case stop to laparotomy. Totally 7 cases occurred complications,each case was cured：2 cases occurred infection of incisional wound, 3 cases occurred pheumonia,2 cases occurred bile leakage.6 months to 3 years was followed up postoperative （an average of 18 months,26 cases over 12 months）,no residual stone occurred.Conclusion Laparoscopy,choledochoscopy combined with holmium laser lithotripsy treatments on elderly patients with cholelithiasis had many advantages：safe,effective,besides small trauma,lesser complications,rapid postoperative recovery,expand the surgical operation age and the operation group.