肝内外胆管结石腹腔镜、内镜联合微创手术方案研究

目的:研究肝内外胆管结石腹腔镜、十二指肠镜、胆道镜联合微创治疗方案。方法:回顾分析2000年10月至2009年10月为671例患者微创治疗肝内外胆管结石的临床资料。采用一镜Ⅰ方案治疗321例,一镜Ⅱ方案治疗12例;二镜Ⅰ方案治疗216例,二镜Ⅱ方案治疗67例,二镜Ⅲ方案治疗5例;三镜Ⅰ方案治疗46例,三镜Ⅱ方案治疗31例。结果:用内镜、腹腔镜联合微创治疗方案治疗肝内外胆管结石成功657例,总成功率97.9%(657/671),术后无严重并发症发生及死亡病例。结论:肝内外胆管结石临床表现多样,采用相应的内镜、腹腔镜联合微创治疗方案,拓宽了微创治疗范围,疗效满意。

Investigation of laparoscopic combined with endoscopic mini-invasive operative program for intrahepatic and extrahepatic bile duct calculus

Objective:To investigate the mini-invasive treatment program combined with laparoscopy,duodenoscopy and choledochoscopy for intrahepatic and extrahepatic bile duct calculus.Methods:The clinical data of 671 patients who suffered from intrahepatic and extrahepatic bile duct calculus and underwent mini-invasive treatment from Oct.2000 to Oct.2009 were retrospectively analyzed.321 cases were treated by the one-scope plan Ⅰ,12 cases by the one-scope planⅡ,216 cases by the two-scope planⅠ,67 cases by the two-scope planⅡ,5 cases by the two-scope plan Ⅲ,46 cases by the three-scope planⅠ and 31 cases by the three-scope planⅡ.Results:Six hundred and fifty-seven cases of intrahepatic and extrahepatic bile duct calculus were successfully treated by endoscopic combined with laparoscopic minimally invasive program,the total achievement ratio is 97.9%(657/671).No severe postoperative complications occurred and no patient died.Conclusions:Intrahepatic and extrahepatic bile duct calculus has various clinical manifestations,selecting corresponding minimally invasive treatment combined with endoscopy and laparoscopy,the treatment range can be widened and the curative effect is satisfactory.