腹腔镜下胆总管探查取石术91例

目的：探讨腹腔镜下胆总管探查取石术的优点、方法、适应证及术后胆总管Ⅰ期缝合术的必要条件。方法：分析91例胆囊结石合并胆总管结石患者行腹腔镜胆囊切除、胆总管切开取石术的术式及病例资料特点。结果：91例患者均在腹腔镜下成功完成胆囊切除、胆总管切开取石术，无中转开腹，平均手术时间105min，平均出血65ml，平均住院6、8d。3例患者术后出现轻微胆漏，保守治疗4～5d后痊愈；其余患者术后无严重并发症发生。结论：腹腔镜下胆囊切除、胆总管切开取石术具有微创、安全的优点，在严格把握手术指征的前提下，是值得推广的临床治疗胆总管结石的手术方式。

Evaluation of laparoscopic common bile duct exploration and calculus removed: with a report of 91 cases

Objective:To discuss the advantage,method,indication of laparoscopic common bile duct exploration and calculus removed and the prerequisite of primary ductal closure.Methods:The mini-invasive operative methods and clinical characteristics of 91 cases with common bile duct calculus and gallbladder calculus treated with laparoscopic cholecystectomy and common bile duct expoloration T-tube drainage were analyzed.Results:Ninety-one cases were successfully accomplished,no case was converted to open operation.The mean operating time,blood loss and postoperative hospitalization were 105min,65ml and 6.8d respectively.Bile leakage occurred in 2 cases and was cured with conservative treatment,and there were no severe complications occured in other patients.Conclusions:Laparoscopic common bile duct exploration and calculus removed has the advantage of less invasion and safety.It would be a operative methods to be spreaded if we follow suitable indication.