腹腔镜下经胆囊管取石治疗胆囊结石合并非扩张性胆总管结石

目的探讨腹腔镜下经胆囊管取石治疗胆囊结石合并非扩张性胆总管结石的临床价值。方法腹腔镜下切除胆囊之前切开胆囊管,插入C管行胆道造影,发现胆总管结石后,在C形臂X线机透视下,经胆囊管插入金属网篮或取石球囊,取出胆总管结石同时经胆囊管放置C管引流。结果36例手术均获成功,结石全部取净。手术时间90～150min,平均125.4min;术后住院时间4～7d,平均5.4d;C管引流时间3～4d。36例术后随访3个月,B超检查均无胆漏,无胆道残余结石,无胆总管狭窄或扩张。结论腹腔镜下经胆囊管取石治疗胆囊结石合并非扩张性胆总管结石,具有创伤小、效果好、并发症少、恢复快等优点,是一种值得推荐的微创治疗方法。

Laparoscopic Transcystic Duct Exploration for Cholecystolithiasis Complicated with Stones in the Non-Dilated Common Bile Duct

Objective To investigate the efficacy of laparoscopic transcystic duct exploration for cholecystolithiasis complicated with stones in the non-dilated common bile duct.Methods Before the resection of the cyst,the cystic duct was cut under a laparoscope,and then a C tube was inserted for cholangiography.Stones in the common bile duct were removed under the guidance of C-arm X-ray.Then,C-tube drainage was carried out after removal of the calculi.Results The stones were completely removed in all of the 36 cases with a mean operation time of 125.4 minutes(90-150 minutes).The C-tube was withdrawn in 3 or 4 days after the operation.The mean postoperative time of this series was 4 to 7 days.The patients were followed up for 3 months,during which no patients had biliary leakage,residual stones,or stenosis or dilation of the common bile duct.Conclusions Laparoscopic transcystic duct exploration is minimally invasive,safe,and effective for cholecystolithiasis complicated with stones in the non-dilated common bile duct.