腹腔镜联合胆道镜微创保胆取石术治疗胆囊结石

目的评价腹腔镜联合胆道镜微创保胆取石术治疗胆囊结石的临床应用价值。方法收集我院2006年1月～2010年12月收治的胆囊结石患者120例,均采取经腹腔镜下切开胆囊底部应用纤维胆道镜进行取石,保留功能良好的胆囊。术后第2 w B超复查结石取尽率,术后1年复查胆囊收缩功能、胆囊壁厚度及胆囊结石复发。结果全部病例成功实现了保胆取石术,平均手术时间55 min,平均住院时间4.2 d。术后第2 w B超检查结石取净率100%,术后1年复查胆囊收缩功能和胆囊壁厚比术前明显改善,术后随访1年胆结石复发6例。结论经腹腔镜微创保胆取石术具有安全性高、创伤小、痛苦少、恢复快、复发率低等特点,且可保留有功能的胆囊,具有临床推广价值。

Treatment of cholecystolithiasis by laparoscope combined with choledochoscopic gallbladder-preserving lithotomy

Objective To evaluate the clinical application value of laparoscope combined with choledochoscopic gallbladder-preserving lithotomy to the treatment of cholecystolithiasis.Methods 120 patients with cholecystolithiasis were hospitalized from January,2006 to December,2010.They received the choledochoscopic lithotomy through the cut-open in the gallbladder bottom under the laparoscope.Their gallbladders with good function were preserved.Two weeks after the operation,the rate of thoroughly removing of gallstones was examined by B ultrasound.One year after the operation,the gallbladder systolic function and the thickness of gallbladder wall and the recurrence of cholecystolithiasis were reexamined.Results The gallbladder-preserving lithotomy in all the cases was successful.The average operation time was 55 min,and the average length of stay in hospital was 4.2 d.Two weeks after the operation,the rate of thoroughly removing of gallstones was 100%.One year after the operation,gallbladder systolic function and the thickness of gallbladder wall were significantly improved.In the one-year follow-up after the operation,the recurrence of gallstone occurred in 6 cases.Conclusion Laparoscopic gallbladder-preserving lithotomy has characteristics of high security,small trauma,less pain,rapid recovery and low recurrence.It preserves the function of gallbladder and has good clinical application value.