摘要
目的探讨胆囊管结石行腹腔镜胆囊切除术(LC)手术处理方式选择。方法回顾性分析2007年7月～2011年7月我院肝胆胰脾外科行腹腔镜胆囊切除术成功治愈的48例胆囊管结石病人的临床资料和手术过程。结果 48例均行腹腔镜胆囊切除术,根据胆囊管结石大小与位置采用不同方式将胆囊管远端部分敞开,用弯分离钳自胆总管向胆囊管方向交替推挤的方式处理胆囊管结石,均取得满意疗效。其中手术相关并发症发生2例,一例胆漏引流后痊愈,一例腹腔出血后进腹止血,未发现胆总管结石,胰腺炎等并发症。结论灵活运用LC的处理技巧是腹腔镜胆囊管结石手术成功的关键,且应重视发现和处理胆囊管结石,避免遗漏,如疑有结石,胆囊管游离要充分,以便开放取石后便于夹闭胆囊管残端,操作切忌粗暴,避免胆管损伤,胆漏。
Objective To summarize our experience in the mangement of cystic duct stone at cystic duct during laparosocopic cholecystectomy and their treatment.Methods From July 2007 to July 2011,We retrospectively analyzed clinical data and surgical procedures of 48 cases of cystic duct stones with laparoscopic cholecystectomy（LC）.Results All the cases underwent LC.According to the size and location of cystic duct stones in different ways to open the distal part of the cystic duct and push approach direction from the common bile duct to the cystic duct alternately.46 cases is satisfactory outcome,one case ofrecovery after drainage of bile leakage,one case of intra-abdominal bleeding and abdominal bleeding backward.All the cases were not found in common bile duct stones,pancreatitisand other complications.Conclusion It is key to flexible use of LC processing skills and pay attention to detection and treatment of cystic duct stones in laparoscopic surgery.By fullyfree cystic duct it is easy to open stone after the cystic duct occlusion stump with suspected stones case and the operation should not rude,to avoid bile duct injury,bile leakage.
出处
《肝胆外科杂志》
2011年第6期429-430,共2页
Journal of Hepatobiliary Surgery
关键词
腹腔镜胆囊切除术
胆囊管
结石
Laparosocopic cholecystectomy
Cystic duct
Stone
