腹腔镜下胆道镜保胆取石术治疗胆囊结石的临床疗效观察

目的:探讨腹腔镜辅助下胆道镜保胆取石术在治疗胆囊结石的应用价值。方法:2008年3月-2010年1月我院为32例胆囊结石患者行腹腔镜辅助下胆道镜保胆取石术。切除胆囊底部,胆道镜检查取净结石,用3-0可吸收线两层缝合胆囊。结果:32例患者均治愈,手术时间为70～110min,平均(92.37±10.36)min;肛门排气时间为24～36h,平均(28.18±2.84)h;无胆漏及其他并发症发生,术后5～8d痊愈出院,术中无胆管损伤,术后未出现腹胀、腹泻、反流性食管炎等并发症。术后随访3～18个月,患者的胆囊收缩功能为15%～35%。结论:腹腔镜联合胆道镜行胆囊部分切除术治疗胆囊结石,对保护胆囊及胆囊功能具有重要意义。

The Clinical Efficacy of Laparoscopic Partial Cholecystectomy for Cholecystolithiasis in Patients with Gallstone

Objective:To discuss the clinical value of laparoscopic partial cholecystectomy in the treatment of cholecystolithiasis.Methods:From Mar 2008 to Jan 2010,32 patients with cholecystolithiasis underwent laparoscopic partial cholecystectomy in our hospital.The bottom of gallbladder was removed,then all the stones were removed by choledochoscope,gallbladder was two layeredly sutured with 3-0 absorbable line.Results:All the patients were cured.The operation time was 70～110(92.37±10.36)min.Postoperative exsufflation time was 24～36(28.18±2.84)h.The postoperative hospital stay was 5～8 days.Bile leakage and other complications hadn't occurred.In the follow-up of 3 to 18 months,the contractibility of gallbladder in patients once had gotten cholecystolithiasis was 15%～35%.Conclusion:The laparoscopic partial cholecystectomy combined with choledochoscopy in the treatment of cholecystolithiasis is meaningful for protecting gallbladder and cystic function.It is feasible for some patients and a new surgery for preservation of gallstone.