直视微创胆道手术87例报告

目的通过直视微创胆道手术技术（MEBS）的应用，减少肝外胆道手术的创伤，并探讨其手术方法和技巧。方法应用MEBS系列器材和相应的手术步骤，完成胆囊摘除87例，胆总管切开“T”管引流8例，胆总管-十二指肠吻合5例。结果微小单孔状切口（2—3cm），手术时间短，出血量少，无术后出血、黄疸等并发症，术后迷走胆瘘1例。结论MEBS达到了LC的相同微创效果，无需全麻和二氧化碳气腹，直视下的微创操作相对安全，手术操作较容易掌握，设备投资小，医疗费用低，具有良好的社会效益和推广价值。

The reports of 87 cases of minimally invasive biliary tract surgery under direct view

Objective To avoid the damage of extrahepatic duct, the minimally invasive biliary tract surgery under direct view was used, and the operative technique and methods was discussed. Methods By u-sing this kind of invasive method,87 cases of cholecystectomy, 8 cases of eholedocholithotomy with T-tube drain-age and choledochoduodenostomy were performed successfully. Results Though a 2-3 cm single-pole incision, the extrahepatic duct operation can be done with less operative time and bleeding. Although there was 1 case of biliary fistula,the postoperative complications of jaundice and bleeding can be avoided. Conclusion This meth-od can achieve the minimally invasive effect of laparoscopy operation with no need of general anesthesia and pneumoperitoneum. The safety and low medical cost of this method deserve the clinical expansion.