腹腔镜联合胆道镜探查治疗胆总管结石的临床研究

目的 探讨腹腔镜下胆总管探查治疗胆总管结石的可行性及临床效果.方法 对 2011 年 9 月至 2013 年 3 月上海市第十人民医院运用腹腔镜胆总管探查 150 例的临床资料分析.结果 119 例（ 79.3% ）胆总管切开探查取石并一期缝合,住院时间为（ 5.73 ± 1.21 ） d,24 例（ 16.0% ）经胆囊管探查胆总管并取石,3 例（ 2.0% ）留置＂T＂管引流,3 例（ 2.0% ）胆总管残石经内镜取石治愈,1 例胆管残石保守治疗,4 例（ 2.67% ）中转开腹,7 例（ 4.67% ）胆漏经腹腔引流管、或留置鼻胆管引流治愈.结论 腹腔镜胆总管探查术是安全可行经济的微创手术.

Clinical study of combined laparoscopy and choledochoscopy choledochus stones

Objective To investigate the clinical effect and feasibility of laparoseopy combined with choledochoscopy in treatment of choledochus stones. Methods We retrospectively analyzed the clinical date of 150 patients underwent laparoscopic common bile duct exploration from September 2011 to March 2013. Results One hundred and nineteen patients （79.3%） were treated successfully with primary suture of laparoscopic common bile duct exploration. Mean postoperation hospital stay was （5.73 ~ 1.21）d. Twenty-four patients （16.0%） were treated with choledochoscopic common bile duct time exploration through gallblader duct. Three patients （2.0%） with T tube drainage. Three patients （2.0%） were found the residual bile duct stones which were successfully removed by postoperative endoscopic therapy. One patient was found the residual bile duct stones without removed. Four patients （2.67%） were converted to laparotomy. Seven patients （4.67%） with bile leakage were treated successfully by abdominal cavity drainage or ENBD. Conclusion Laparoscopic common bile duct exploration is safe, feasible, economical and minimally invasive.