三孔法腹腔镜胆总管切开取石术的临床应用

目的:探讨三孔法腹腔镜胆总管切开取石术的可行性及手术方法。方法:回顾分析为35例患者行三孔法腹腔镜胆总管切开取石术的临床资料。结果:33例成功完成手术,2例因皮下广泛气肿而直接中转开腹。手术时间85～198 min,平均(125±21.4)min;术中出血量平均(86±7.5)ml;术后均无结石残留、胆漏及死亡病例。结论:在熟练掌握三孔法腹腔镜胆囊切除术的基础上,开展三孔法腹腔镜胆总管切开取石术是安全、可行、有效的,更符合微创理念,值得临床推广应用。

Clinical application of three-port laparoscopic choledocholithotomy

Objective: To investigate the feasibility and operative method of three-port laparoscopic choledocholithotomy.Methods: The clinical data of 35 patients with choledocholithiasis who were treated with three-port laparoscopic choledocholithotomy were retrospectively analyzed.Results: The operations of 33 patients were successful.2 patients were directly converted to laparotomy due to subcutaneous wide emphysema.The operative time was 85 to 198 min with an average of(125 ± 21.4) min.Intraoperative blood loss was(86 ± 7.5) ml.There was no postoperative residual stone,bile leakage or death.Conclusions: The three-port laparoscopic choledocholithotomy is safe,feasible,effective and mini-invasive on the basis of skillful mastering three-port laparoscopic cholecystectomy,and is worthy of clinical application.