摘要
目的：探讨分析腹腔镜联合胆道镜治疗胆囊结石并胆总管结石的方法。方法：我院2008年3月至2009年12月收治26例胆囊结石并胆总管结石患者,腹腔镜胆囊切除术中切开胆囊管或胆总管,行纤维胆道镜胆总管取石术。结果：26例患者均按常规行腹腔镜胆囊切除术,12例行胆囊管切开取石术,胆总管未放置＂T＂管;14例行胆总管切开取石术,其中8例未放置＂T＂管,行一期缝合,6例胆总管内放置＂T＂管,术后6-8周行纤维胆道镜检查,2例发现残余结石,并取净,4例未发现胆总管残余结石,再次行胆道造影后未发现结石,拔除＂T＂管。所有病例均无并发症发生。结论：腹腔镜胆囊切除联合纤维胆道镜取石术治疗胆囊结石并胆总管结石,患者创伤小,康复快,安全有效。术中不能取净胆总管结石者,术后可通过＂T＂管窦道行纤维胆道镜取石。
Objective：To investigate the method of laparoscopy combined with choledochoscopy on common bile duct（CBD） stones and gallbladder stone.Methods：Twenty-six patients of gallbladder stone companied with CBD stones from Mar.2008 to Dec.2009 underwent laparoscopic cholecystectomy（LC） and choledochoscopic common bile duct cholelithotomy through incision on the bile duct or common bile duct.Results：Twenty-six cases were performed LC routinely,12 cases underwent ductus cysticus lithotomy,without T tube.14 cases underwent CBD lithotomy,among them 6 cases of T tube was put into the CBD,8 cases received the primary suture of the CBD,without T tube.Choledochoscopic exploration was performed 6-8 weeks after operation,2 cases of residual stone were found and dislodged.Biliary tract visualization confirmed no stones were remained,then T tube was removed.No complication happened in all cases.Conclusions：Laparoscopy combined with choledochoscopy is a safe and effective operation for patients of gallbladder stone companied with CBD stones with fewer invasions,less pain and quicker recovery.Residual calculus of common bile duct which is difficult to remove during operation can be removed by fibrocholedochoscopic cholelithotomy through T tube sinus tract postoperatively.
出处
《腹腔镜外科杂志》
2010年第6期474-475,共2页
Journal of Laparoscopic Surgery
