腹腔镜胆总管切开取石的临床应用研究

目的:探讨腹腔镜纤维胆道镜胆总管切开配合取石(LCDE)的安全性。方法:回顾分析胆囊、胆总管结石合并阻塞性胆管炎15例,其中合并肝内胆管结石3例,以及单纯胆囊结石合并急性阻塞性胆管炎3例的临床资料。18例术前均经影像学检查包括BUS、CT、MR或MRCP,在全身麻醉下行腹腔镜手术。结果:全组均成功完成手术,无中转手术,术中无大出血,无胆管损伤。术后胆漏2例。手术时间90~200m in,平均125m in,术后5例有胆道残余结石,用纤维胆道镜取尽。结论:腹腔镜胆总管切开取石安全可靠,手术创伤小且并发症少。

A study of the laparoscopic choledocholithotomy and its clinical application

Objective:To assess the safety of the laparoscopic choledocholithotomy combined fibercholedochoscopy in operation.Methods: The data of 15 cases of cholelithiasis complicating obstructive cholangitis,including 3 cases with hepatolithiasis,and 3 cases of cholecysto lithiasis complicating acute obstructive cholangitis were retrospectively analyzed.The preoperative image examination includined BUS?CT?MR or MRCP and all the cases were treated by laparoscopy.Results:All the laparoscopic operations were performed successfully without conversion to open operation,serious bleeding and bile duct injury,while bile leakage occurred in 2 cases.The operative time ranged from 90 to 200 minutes and the average time was 125 minutes.5 cases had residual stones,treated by fibercholedochoscopy postoperatively.Conclusions: The laparoscopic bile duct exploration is safe with less trauma and complications.