腹腔镜联合胆道镜胆总管切开取石治疗胆石症

目的:探讨腹腔镜联合胆道镜行胆囊切除、胆总管切开取石的疗效和方法。方法:回顾分析53例腹腔镜联合胆道镜胆囊切除、胆总管切开取石治疗肝外胆管结石的临床资料。结果:手术成功切除胆囊49例,完成胆总管切开探查取石、T管引流术44例,中转手术9例,全部患者恢复顺利,无严重并发症。结论:腹腔镜联合胆道镜治疗胆囊炎胆结石、肝内外胆管结石疗效可靠、安全,充分体现了微创治疗的优点;但分离时遇到粘连严重、易出血、解剖困难应及时中转开腹手术,以免发生严重后果。

The treatment of cholelithiasis by laparoscope combine with choledocho scope to cholecystectony and choledoch lithotomy

Objective: To investigate the treatment effect and method of applyiing laparoscope in combining with choledochoscope to cholecystectomy and choledocho lithotomy.Methods:The clinical data of 53 cases of cholecystolithiasis of hepatic duct and cystic duct undergoing cholecystectomy and choledocholithotomy applying laparoscope in combination with choledochoscope were reviewed.Results:Satisfactory outcome was realized in 49 cases of cholecystectomy,44 cases of choledocholithotomy and T-tube drainage,except conversion occured in 9 for duodennal injury.All patients recovered without serious complication.Conclusions: The combination procedure is feasible and safe.But when serious adherence,hemorrhage and dissection difficulty occurring,proper conversion was necessary.