胆囊结石合并胆囊结肠瘘或胆囊十二指肠瘘的诊治

目的：探讨胆囊结石合并胆囊结肠瘘或胆囊十二指肠瘘的原因及腹腔镜手术治疗。方法：回顾分析2000年至2006年收治的12例患者的临床资料。结果：胆囊结石合并胆囊结肠瘘或胆囊十二指肠瘘占胆囊结石合并症的3．2％，有严重急性胆囊炎史，B超及术中探查见胆囊萎缩，术中造影可确诊。本组12例均在腹腔镜下完成手术，术后无明显并发症。结论：对有急性胆囊炎病史，术前或术中发现胆囊萎缩的病例应考虑到胆囊结肠瘘或胆囊十二指肠瘘，确诊后可行腹腔镜外科手术。

The diagnosis and treatment of cholecystolithiasis with cholecystocolonic fistula or cholecystoduodenal fistula

Objective:To explore the etiology and treatment of cholecystolithiasis combined with cholecystocolonic fistula or cholecystoduodenal fistula.Methods:12 patient's clinical data were retrospectively analysed between 2000 and 2006.Results:It is 3.2% for the cholecystolithiasis combined with cholecystocolonic fistula or cholecystoduodenal fistula in cholecystolithiasises,that may have the history of serious acute cholecystitis.A trophy of gallbladder can be found by B ultrasound or exploration in operation and it can be final diagnosed by intraoperative cystography.All the cases were cured by laparoscopy and no complications happened.Conclusions:It should be considered for the cholecystolithiasis combined with cholecystocolonic fistula or cholecystoduodenal fistula when the case had the history of serious actue cholecystitis or was found atrophy of gallbladder before operation or during operation,which can be treated by laparoscopy.