探讨纤维胆道镜在低创胆道手术中的应用

目的探讨应用纤维胆道镜施行低创胆道手术的可行性。方法小切口胆囊切除基础上，应用纤维胆道镜胆总管切开取石一期缝合873例，经胆囊管纤维胆道镜探查网篮取石58例，不放置T管引流。结果931例小切口胆道手术未放置T管。均获得满意的低创效果，平均术后7d出院。未发现严重并发症，无1例结石残留及胆道梗阻发生。结论在小切口胆道手术中应用胆道镜可使胆道手术低创化，效果确切。选择性一期缝合胆总管或经胆囊管胆道镜网篮取石是安全、可行的。该术式不放置T管引流，避免了与T管伴随的并发症。最大程度减轻患者痛苦。缩短病程，值得推荐应用。

Application of choledochofiberoscope in less-invasive operation for biliary diseases

Objective] To evaluate the feasibility of applying choledochofiberoscope in less-invasive operation for biliary diseases. [Method] Investigation was carried out on the basis of 931 cases of mincholecystectomy, and choledochofiberoscope was used in all cases.873 cases got primary bile duct suture after bile duct exploration via CBD incision, while 58 cases underwent bile duct exploration via cystic duct for stone removal with grasping basket.T-tube drainage was not appled in all cases. [Result] Less-invasiveness was gotten in all those cases with a 7-day mean hospitalization time. No severe complication occurred, and there existed no residual stones and bile duct stricture. [Conclusion] Application of choledochofiberoscope is definitely valuable in achieving less-invasiveness in operation for biliary diseases and primary sture of bile duct is proven safe and feasible. Without T-tube drainage and its corresponding complication, this method desense wider use for its value in alleviating patient`s sufferings and shortening hospital stay.