摘要
目的探讨胆囊结石合并肝外胆管结石的微创治疗方法、适应证和安全性。方法选择胆囊结石合并肝外胆管结石患者90例,分别行腹腔镜、胆道镜、十二指肠镜三镜联合和腹腔镜、胆道镜两镜联合手术,并观察术后临床表现。结果三镜组34例,中转开腹1例(2.94%);腹腔镜手术平均历时92min;术后发生胆漏2例,无其他并发症,无死亡;术后平均住院日8d。两镜组56例,中转开腹3例(5.36%);手术平均历时73min;残余结石2例,未发生胆漏,无其他并发症,无死亡;术后平均住院日6.5d。结论三镜联合或两镜联合治疗胆囊结石合并肝外胆管结石具有微创、安全的优点;三镜联合分期治疗更适合于合并急性梗阻性化脓性胆管炎患者;两镜联合治疗对于非急性炎症期患者更经济、更安全,患者更易接受。
[Objective] To discuss the minimally invasive treatment methods,indications and safety for treating cholecystolithiasis associated with calculus of extrahepatic bile duct.[Method] 90 patients with cholecystolithiasis associated with calculus of extrahepatic bile duct were respectively treated by joint endoscopes and three endoscopes combined and observing clinical manifestations after operation.[Results] Among the 34 patients treated by three endoscopes combined,1case were performed laparotomy halfway（2.94%）,2 cases with bile leakage,and there was no other complication and no death.The mean operative time was 92 minutes.The mean postoperative hospital stay was 8 days.Among the 56 patients treated by joint endoscopes,3 case were performed laparotomy halfway（5.36%）,2 cases with residual stones,and there was no bile leakage,no other complication and no death.The mean operative time was 73 minutes.The mean postoperative hospital stay was 6.5 days.[Conclusion] There are advantages such as minimal invasion and safety when treating cholecystolithiasis associated with calculus of extrahepatic bile duct by joint endoscopes and three endoscopes combined.The stage treatment by three endoscopes combined is more suitable for acute obstructive suppurative cholangitis patients.The joint endoscopes therapy in patients with non-acute inflammation is more economical,more secure and more acceptable.
出处
《中国内镜杂志》
CSCD
北大核心
2011年第11期1193-1195,1200,共4页
China Journal of Endoscopy
关键词
胆囊结石
肝外胆管结石
微创
cholecystolithiasis
calculus of extrahepatic bile duct
minimally invasive
