经胆囊管行胆总管探查术46例报告

目的　探讨经胆囊管行胆总管探查术的可行性和适应证。方法　对择期行胆囊切除胆总管探查术病例中胆囊管直径大于 0 .3cm的 46例患者实施经胆囊管探查胆总管手术 ,其中胆囊管直径大于 0 .5cm的 1 6例采取直接扩张胆囊管后探查 ,胆囊管直径 0 .3 -0 .5cm的 3 0例采取先切开胆囊管 ,扩张胆囊管汇入部后再进行胆道探查。结果　手术均获成功 ,合并胆总管结石的 3 5例结石取净 ,全组病例恢复顺利 ,术后平均住院时间 7.3d ,无胆漏等相关并发症发生。结论　有选择的实施经胆囊管探查胆总管手术安全可行 ,可以避免常规探查手术放置T管的诸多并发症和缝合胆管可能导致的胆漏、狭窄、结石形成等远期并发症

Report from 46 exploration operations of common bile duct through cystic duct

Objective To explore the possibility and availability for exploration operations of common bile duct through cystic duct. Methods Among the patients who are arranged for exploration operations of common bile duct, to 46 patients, whose cystic duct has dimension larger than 0.3 cm, the exploration operations through cystic duct have been done for them; to the 16 patients, whose cystic duct has a dimension larger than 0.5 cm, the exploration operations have been done after the cystic duct being dilated; to the 30 patients, whose cystic duct has a dimension between 0.3-0.5 cm, for them, cystic duct has been cut open first, then the entry part has been dilated before the cystic duct exploration has been done. Results All operations are successful. The calculi have been extracted completely for 35 patients with common bile duct calculi, and all the group got recovered successfully. The average days in hospital is 7.3 days. No complications occurred such as bile leak. Conclusions It is safe and available to selectively have exploration operations of common bile duct through cystic duct. It can avoid such complications caused by placing T tube for conventional exploration by bile duct suture leading the formation of stricture and calculi.