腹腔镜胆总管探查术587例临床分析

目的总结腹腔镜胆总管探查术的治疗经验。方法对1992年6月至2006年5月在我院行腹腔镜胆总管探查术的587例患者的资料进行回顾性分析。结果585例患者行腹腔镜胆总管探查术成功,2例中转开腹,成功率99．7％;手术时间60～230min,平均85min。术后发生胆漏13例,十二指肠损伤1例,腹腔残石致引流管口脓肿形成1例,胆管残石35例,T管引流出钛夹3例。所有患者术后第2天进流质食物并下床活动,平均住院4．6d。结论腹腔镜胆总管探查术对于治疗胆管结石是安全有效的手术方式。

Clinical evaluation of laparoscopic common bile duct exploration in 587 cases

OBJECTIVE: To summarize the experience of laparoscopic common bile duct exploration. METHODS: The clinical data of 587 cases who underwent laparoscopic common bile duct exploration from June 1992 to May 2006 were analyzed. RESULTS: The surgery was successful in 585 cases (99.7%), 2 cases were converted to open common bile duct exploration. The duration of operation was 60 approximately 230 min (averaged 85 min), the complications consisted of biliary fistula (n=13), injury of the duodenum (n=1), abscess of drainage tube orifice (n=1), titanium clip discharging out from T tube (n=3), residual common bile duct stones (n=35). The patients could take food and walk on the second postoperative day and average postoperative hospital stay was 4.6 days. CONCLUSIONS: Laparoscopic common bile duct exploration is a safe and effective procedure in treating the calculus of bile duct.