腹腔镜下经胆囊管胆道镜胆总管探查取石27例治疗体会

目的探讨腹腔镜胆囊切除术中应用纤维胆道镜经胆囊管入路治疗胆总管结石的效果及临床意义.方法采用Olympus CHF p20胆道镜经胆囊管入路施行胆总管探查取石术27例,其中直接置入胆道镜19例,经胆囊管胆总管汇合处微切开胆总管侧壁置入胆道镜8例.结果 27例均痊愈出院,无胆漏、腹腔感染、结石残留、出血、胆管狭窄等并发症的发生,术后住院时间5～10d.结论该术式对有适应症的患者,可避免和减少胆总管完整性的破坏和术后并发症,缩短住院时间,为部分胆总管结石患者较为理想的术式.

27 Cases of Common Bile Duct Exploration Surgery by Choledochoscope via Cystic Duct under Laparoscope

Objective To explore the application of choledochofiberscope via the cystic duct in laparoscopic cholecystectomy to treat common duct stones.Methods 27 cases of common bile duct exploration surgery via cystic duct by Olympus CHF p20 cholangioscope were performed,among which cholangioscopes were directly inserted into common bile duct in 19 cases,and in the other 8 cases cholangioscopes were inserted after micro-incision into part of the common bile duct which meet the cystic duct.Results All of the 27 patients got release after recovery without bile leakage,intra-abdominal infection,stone residue,hemorrhage or biliary stricture.The stay time of patients in hospital was 5～10 days.Conclusion To some patients with indications,the operation can avoid or reduce the injury of the common bile duct,reduce post-operative complications,shorter the stay time in hospital,and may be a more ideal surgical method to some patients with common bile duct stones.