腹腔镜手术治疗胆囊结石合并胆总管结石的临床研究

目的 探讨腹腔镜微创手术在治疗胆囊结石合并胆总管结石疾病中的价值。方法 回顾性分析了1996年1月～2004年9月在该院确诊为胆囊结石胆总管结石的病人采用腹腔镜手术的治疗情况，并对多种治疗的选择方案、结果作了分析比较。结果 68例患者中大多数在腹腔镜下一期作了胆囊切除、胆总管切开胆道镜下取石T管引流，未发现有明显并发症。少数胆总管无扩张的病例由内镜下作EST后联合腹腔镜胆囊切除术二期完成治疗，极少数上述方案治疗失败的患者由开腹完成治疗。腹腔镜手术一期治疗与内镜、腹腔镜联合二期治疗和开腹手术相比较，病人住院时间短，恢复快，并发症少，手术成功率高，具有明显的优点，而手术时间并无延长。结论 腹腔镜下手术一期取除结石是治疗胆囊结石合并胆总管结石的主要、较好的选择方案。

Clinical research on laparascopic management for patients with both gallbladder and common bile duct stones

To investigate the therapeutic status of laparoscopic management for gallbladder stones and common bile duct stones. A Retropective study were adopted to analysize the therapeutic scheme, effect for patients with gallbladder stones and common bile duct stones who were treated from January 1996 to September 2004. 68 cases were diagnosed, and most of them underwent single stage laparoscopic cholecystectomy (LC) and common bile duct exploration (LC BDE). A few of them were treated through endoscopic procedure in combination with LC, or open surgery when the minimal invasive surgery failed. Conclusions] Both them indicated that patients by LC+LCBDE have shorter hospital stay, easier recovery and less complications. LC+LCBDE has obvious advantage over the other methods with appropriate operative time and high success rate. For choledochlithiasis patients, the single laparoscopic management should be a better, major option.