腹腔镜手术治疗胆囊颈管结石的效果观察

目的探讨胆囊颈管结石的临床特点和行腹腔镜胆囊切除手术（LC）的技巧。方法对2005年1月-2013年6月本院诊治的136例胆囊颈管结石行LC治疗的临床资料进行统计和回顾性分析。结果经B超、CT检查术前明确胆囊颈管结石96例，术中探查发现胆囊颈管结石40例。其中125例顺利完成LC．11例中转开腹手术。术后发生胆漏6例，均痊愈出院。结论胆囊颈管结石易嵌顿致急、慢性胆囊炎反复发作。LC治疗胆囊颈管结石足安全可行的。对Caloti角粘连致密、解剖变异或不清者适时中转开腹手术可减少并发症的发生。

Efficacy observation of laparoscopic cholecystectomy in treatment of cal- culus in neck and duct of gallbladder

Objective To discuss the clinical features of calculus in neck and duct of gallbladder,and explore the skill of laparoscopie eholecystectomy （LC）.Methods The clinical data of 136 cases of patients with calculus in neck and duct of gallbladder underwent LC from Jan.2005 to Jun.2013 were analyzed retrospectively.Results From B-ultrasonic examination and CT scan,96 cases of calculus in neck and duct of gallbladder were clearly diagnosed before operation, 40 cases were diagnosed during operation.Among them,125 cases were accomplished by LC,11 cases converted into open surgery.Postoperative bile fistula occurred in 6 patients,they were all healed.Conclusion Calculus in neck and duct of gallbladder is relatively easily leaded to incarceration,and then repeated episodes of acute and chronic： chole- cystitis.h is safe and feasible to cure calculus in neck and duct of gallbladder by LC.h can reduce complications when treatment converted to open operation timely in case of Calot triangle adhesion density,anatomic variation or unclear.