腹腔镜胆总管切开取石“T”管引流术78例

目的探讨及总结腹腔镜胆总管切开取石“T”管引流术的临床价值及相关手术经验。方法对本院行腹腔镜胆囊切除、胆总管切开取石“T”管引流术78例患者的临床资料进行回顾性分析。结果77例手术成功,1例中转开腹,成功率98.7%,手术时间70-190 min,平均95 min。术后发生胆漏1例,保守治疗后治愈;1例胆道残余结石术后经胆道镜取净,所有患者术后第二天进食流质并下床活动,平均住院6.8天。72例（随访率92.3%）随访6-36个月,平均14.3月,均无腹痛、发热、黄疸发作。结论腹腔镜胆总管切开取石“T”管引流术创伤小,术后恢复快,是安全可靠且有效的手术方式。

Clinical Evaluation of Laparoscopic Choledocholithotomy With T-tube Drainage in 78 Cases

Objective To investigate and summarize the clinical value and the operative experience of laparoscopic choladochlithotomy with T-tube drainage. Methods 78 cases who underwent laparoscopic choladochlithotomy and common bile duct exploration with T-tube drainage from September 2004 to February 2008 were retrospectively analyzed. Results The operation was successful in 77 cases（98.7%）,1 cases were converted to open surgery.The duration of operation was 70～190min（averaged 95min）.Bile leakage occurred in 1 case and was cured with conservative treatment.Residual stones were found in 1 case and a postoperative choledochoscopy was required.The patients could take food and walk on the second postoperative day and average postoperative hospital stay was 6.8 days.Follow-up checkups in 72 cases（92.3%） for 6～36months（mean 14.3 months） revealed no abdominal pain,fever,or jaundice. Conclusions The laparoscopic common bile duct exploration with T-tube drainage is a safe and effective operation with little injury and quick recovery.