腹腔镜联合胆道镜胆总管切开取石术52例临床疗效观察

目的 探讨腹腔镜联合胆道镜胆总管切开探查取石术的疗效.方法 2009年3月至2012年3月云南省安宁市人民医院普外科对52例患者施行腹腔镜胆囊切除、胆总管切开取石术,回顾分析治疗效果.结果 52例患者均顺利完成手术,2例患者中转开腹,中转率为3.85％,手术时间51～158 min,平均为86 min.其中7例胆总管一期缝合,45例放置T管,3例胆漏,发生率为5.77％,经引流治疗后愈合；6例胆管残留结石,发生率为11.54％,术后3月经胆道镜取出.结论 腹腔镜联合胆道镜胆囊切除、胆总管探查取石术治疗胆总管结石具有安全有效、创伤小、住院时间短、恢复快等优点,值得推广.

The Clinical Curative Effect of Laparoscope Joint Choledochoscope Choledocholithotomy in 52 Cases

Objective To Explore the curative effect of Laparoscope joint choledochoscope Choledocholithotomy.Methods From March 2009 to March 2012,52 patients received Laparoscopic joint choledochoscope choledocholithotomy in The People’s Hospital of Anning.The therapeutic effect was evaluated.Results The Laparoscopic joint choledochoscope choledocholithotomy was successfully completed in 50 patients,and 2 patients were transferred to opening appendectomy with the transfer rate of 3.85%.The operation time was 51-158 minutes,with average of 86 minutes.Among them,7 patients were given one-stage suture of common bile duct,45 patient were placed T tube,3(5.77%)patients were found with bile leakage,and were cured after drainage treatment,6 patients(11.54%)were found with bile duct residual stones which were removed by choledochoscope 3 days later.Conclusion Laparoscopic joint choledochoscope Choledocholithotomy is a safe and effective treatment for common bile duct stones with little trauma,short time and quick recovery,etc,and deserves popularization.