三孔法腹腔镜胆总管探查术21例分析

目的:探讨三孔法腹腔镜胆总管探查与"T"管引流术在临床上的应用价值。方法:采用三孔法行21例手术,于腹腔镜下切开胆总管,纤维胆道镜探查胆总管,取石网篮取石后,置"T"管引流。术后45d拔"T"管,经"T"管窦道纤维胆道镜探查肝内外胆道情况。结果:手术均获成功,无中转开腹,手术时间(70±24)min,术后无胆漏。术后45d经"T"管窦道纤维胆道镜探查,发现胆总管残余结石2例,肝内胆管结石3例,均经胆道镜取出。结论:三孔法腹腔镜胆总管探查术操作安全、可靠,具有一定的临床应用价值。

Three port laparoscopic common bile duct exploration of 21 cases

Objective:To evaluate the clinical significance of 3-port laparoscopic common bile duct exploration and T-tube drainage.Methods:Twenty-one cases with biliary calculus were performed by laparoscope.The common bile duct(CBD) was incised,explored by biliary fiberendoscope,and then the calculuses were taken out by choledochoscopic net-basket and T-tube drainage.The T-tube was pulled out 45 days after the operation,the intra-and extrahepatic bile duct was then explored by binary fiberendoscope through the T tube tract.Results:All the cases were operated successfully,and no one was converted to open surgery.The operation time was(70±24)min.No biliary leakage was found after the operation.2 cases of residual calculus in CBD and 3 cases in intrahepatic bile duct was found by binary fiberendoscope 45 days after the operation,which were all taken out by binary fiberendoscope.Conclusions:Three-port laparoscopic common bile duct exploration is a safe and reliable technique with high clinical value.