胆管结石微创手术治疗的临床应用

目的探讨胆道镜在腹腔镜胆管结石手术中应用的价值。方法利用胆道镜灵活的转向、柔和的弯曲性，对腹腔镜下剖开胆总管的远端及肝内胆管进行探查、术中取石、狭窄胆管的治疗。结果本组72例胆管结石患者均术中应用胆道镜探查，单纯胆总管结石51例，术中取净47例；单纯肝内胆管结石12例，术中取净5例；肝内外共存结石9例，术中取净4例；伴有肝内胆管狭窄2例，Oddi括约肌狭窄1例。对2例肝内胆管狭窄及1例Oddi括约肌狭窄进行球囊导管扩张治疗。结论胆道镜在腹腔镜胆管结石手术中的应用，提高了术中结石取出率及取净率；同时可以对胆管及Oddi括约肌狭窄进行诊断和术中治疗，提高了腹腔镜胆管结石一期治愈率。

Application of clinical in choledochotomy and laparoscopic bile duct calculus operation

Objective To investigate the application value of choledochotomy in the operation under laparoscopic to extract bile duct calculus operation. Methods The choledochotomy to freely, winding softly treat common bile duct and liver bile duct exploration, extraction of bile duct calculus and stenosis were used. Results 72 patients who had bile duct calculi were all explorated, 51 of these 47 patients,who had common bile duct calculi are clear in the operation; 12 of these 5 patients who had in hepatolithiasis are clear;9 of these 4 patients who had in hepatolithiasis are clear;2 of these patients had in hepatolithiasis and common bile calculus together are clear,2 patients who had stenosis of liver bile duct and 1 patient stenosis of Oddi sphincter , treatd them by the balloon dilatation catheter. Conclusion The application of choledochotomy to extract bile duct calculi under laparoscopic,improve the extraction and clear rate in the operation,at the same time can diaghosis and treat stenosis of Oddi sphincter in the operation, improve bile duct calculus cure rate and aim the purpose of minimally invasive.