摘要
目的探讨输尿管镜在腹腔镜胆管结石手术中的临床应用价值。方法回顾性分析广西桂东人民医院2007年2月至2009年9月期间应用腹腔镜联合输尿管镜手术治疗的36例肝胆管结石患者的临床资料。结果36例患者中有33例完全在腹腔镜联合输尿管镜下一次完成胆管取石(3例残留胆石在术后2个月经T管二次取石成功),3例因术中胆道和肝门部血管出血及胆管撕裂而中转开腹手术取石;术中出血30～280(94.51±54.70)ml;手术时间110～260(147.22±48.45)min;术后肠蠕动功能恢复时间1～3(2.03±0.76)d;术后住院时间6～13(7.12±1.65)d(带T管出院);T管拔除时间28～45(38.92±6.52)d。术后胆汁漏1例,胆道感染1例,无胆管狭窄、胆道出血或操作孔感染等并发症。结论肝内一级胆管及(或)肝外胆管单发或泥沙样结石,应用腹腔镜联合输尿管镜治疗是可行的,对机体创伤小,术后康复快,是肝内、外胆管结石的又一种微创治疗方法。
Objective To evaluate the clinical value of ureteroscope in cholelithiasis treated by laparoscopic surgery.Methods The clinical data of 36 patients admitted because of hepatolithus with ureteroscope combination in laparoscopic surgery from February 2007 to September 2009 in Guidong People’s Hospital of Guangxi were analyzed retrospectively.Results In 33 cases,stones were removed once by ureteroscope in laparoscopic surgery with residual stones （in 3 cases residual stone were removed secondarily through T tube） and the other 3 cases were transferred to laparotomy forcedly due to bleeding of biliary duct and vessels of porta hepatis and tearing of bile duct.During operation,blood loss was 30-280 （94.51±54.70） ml;operation time was 110-260 （147.22±48.45） min;recovery time of bowel movement was 1-3 （2.03±0.76） d;postoperative hospitalization time was 6-13 （7.12±1.65） d （some discharged with T tube）;the time of patients of T tubes pulled out was 28-45 （38.92±6.52） d.Bile leakage happened in 1 case and infection of biliary tract in 1 case,no complications such as biliary stricture or bile duct bleeding were found after operation.Conclusions Treatment of intrahepatic bile duct or a single extra-hepatic sand-like stones with ureteroscopy usage in laparoscopic surgery is feasible and less invasive.It is a minimally invasive treatment for intra-or extra-hepatic stones due to rapidly postoperative rehabilitation.
出处
《中国普外基础与临床杂志》
CAS
2010年第4期379-382,共4页
Chinese Journal of Bases and Clinics In General Surgery
