??????µ?????????????????

目的：探讨腹腔镜胆总管球囊导管扩张术和扩张导管扩张术在处理胆管狭窄中的临床应用。方法：采用腹腔镜胆总管探查，根据扩张情况对炎性狭窄或膜状狭窄结石取净者，胆管切口即时缝合。段状狭窄结石取净者，塑料支架内引流。恶性狭窄晚期者，自膨式金属支架或塑料支架内引流。结石未取净者，T管外引流。结果：炎性狭窄或膜状狭窄扩张61例，良性段状狭窄扩张37例，恶性太狭窄扩张12例，胆漏6例，残石3例，中转开腹1例，死亡1例。结论：选择合适病人，经腹腔镜胆总管探查术中采用球囊导管或扩张导管扩张胆管狭窄有效、可行。

Clinical application of laparoscopic papillary balloon dilatation and catheter dilatation of bile duct

Objective To evaluate clinical application of laparoscopic papillary balloon dilatation and catheter dilatation in treating the bile duct stenosis. Methods From Oct.1998 to May.2002, 110 patients were treated for the bile duct stenosis by laparoscopy.For those of inflammatory stenosis or membranous stenosis with stones all extracted,the bile duct incision was sutured simutaneously or not.If necessary, we used biliary endoprosthesis,stent, and T tube drainage for the patients with residual stones.Results In all the 110 cases,there were 61 cases of dilation inflammatory bile duct stenosis and membranous stenosis,37 cases of dilatation of benign segmental stenosis and 12 cases of dilatation of malignant segmental stenosis.99 patients had completed successfully to reach the preestablished object in total 110 patients, 6 patients had bile leakage, 3 patients had residual stones in the left intrahepatic bile duct, one patient changed into open abdominal operation, one patient died of the functional failure of the liver and the kidneys. Conclusion Laparoscopic papillary balloon dilatation and catheter dilatation is a feasible and simple method in treating the bile duct stenosis.