胆道镜联合腹腔镜治疗胆囊结石合并肝外胆道结石58例体会

【目的】总结胆道镜联合腹腔镜治疗胆囊结石并肝外胆道结石的体会。并评估其临床疗效。【方法】回顾分析2007年6月至2010年5月胆道镜联合腹腔镜治疗胆囊结石并肝外胆道结石患者的临床资料。【结果】58例患者54例手术成功。手术时间120～240rain，均留置T形管胆道引流。患者术后d，均下床活动和饮水。术后d：进流质饮食。术后7例30d经T形管胆道造影拔除T形管，47例术后45～60d行胆道镜检查治疗后拔除T形管。【结论】胆道镜联合腹腔镜行胆囊切除胆总管切开探查取石术具有创伤小、痛苦轻、恢复快及腹腔脏器干扰小、并发症少等优点，值得，临床推广应用。

Experience of Minimally Invasive Surgery of 58 Cases of Cholecystolithiasis with Extrahepatic Bile Duct Calculus

Objective] To summarize the experience of choledochoseope combined with laparoscope for the treatment of cholecystolithiasis with extrahepatic bile duct calculus and evaluate its clinical efficacy. Methods] The clinical data of patients of eholecystolithiasis with extrahepatic bile duct calculus treated by choledoehoscope combined with laparoscope from June 2007 to May 2010 was analyzed retrospectively. Results] Of 58 patients, 54 cases were operated successfully. Operation time was 120-240 minutes. The biliary drainage of T-tube was indwelled in all patients. At the first day after operation, all patients were ambulate and drank wa- ter. At the second day after operation, all patients ate liquid diet. At 30 days after operation, the T-tube of 7 cases was removed by T-tube cholangiography. At 45-60 days after operation, the T-tube of 47 cases were removed by choledochoscopic examination. Conclusion] Choledoehoscope combined with laparoscope for chol- ecystectomy and choledocholithotomy has advantages such as minimal invasion, slight pain, rapid recovery, little disturbance of abdominal organs and fewer complications, etc. Therefore, it is worth to be generalized in clinical application.