腹腔镜联合胆道镜胆总管探查取石术的临床体会

目的：探讨腹腔镜联合胆道镜在胆总管探查取石术中的应用价值。方法：回顾分析2004年6月至2009年12月应用腹腔镜联合胆道镜治疗35例胆管结石患者的临床资料。结果：35例手术均获成功,无中转开腹,术后1例发生胆漏,保守治疗4d痊愈,平均住院7d,术后6~8周拔除＂T＂管,4例胆管残余结石经＂T＂管窦道Ⅱ期胆道镜取石成功,全组无严重并发症发生。结论：腹腔镜联合胆道镜胆总管探查取石术是治疗胆管结石的理想微创术式。

Clinical experience of laparoscopic and cholangioscopic common bile duct exploration and extraction of bile duct stones

Objective:To discuss the application value of laparoscopic and cholangioscopic common bile duct exploration and extraction of bile duct stones.Methods:The clinical data of 35 patients with bile duct calculus undergoing laparoscopic and cholangioscopic common bile duct exploration from Jun.2008 to Dec.2009 were collected and analyzed retrospectively.Results:Thirty-five cases were operated successfully,no case was converted to open operation.The mean postoperative hospital stay was 7d.All of them were cured,no serious complications were observed.One case of bile leakage occurred and cured by 4d conservative treatment.4 cases of residual bile dult calculi were removed by Ⅱ stage choledochoscopy through T tube sinus.Conclusions:Laparoscopic and cholangioscopic common bile duct exploration and extraction of calculi in treatment of choledocholithiasis is ideal and mini-invasive.