摘要
目的:探讨腹腔镜联合胆道镜在胆总管结石治疗中的临床价值和意义.方法:回顾分析我院2008-04/2011-03以腹腔镜联合胆道镜诊治的107例胆总管结石患者的临床资料,分析其胆总管探查取石的治疗过程,总结双镜联合的治疗意义.结果:本组中有102例双镜联合手术成功,5例中转开腹手术.手术时间:120-150min(平均140min).出血量:20-80mL(平均55mL).术后住院时间:7-15d(平均8.5d).放置腹腔引流管者83例,其中有16例仅术后第1天引流出少量淡黄色液体,3d后无液体引出,第4天拔管.其余术后第1天胆汁引流量约300mL,4d后基本无胆汁引出,第6天拔管.放置T管者于术后4wk拔管.本组全部患者均康复出院,随访3-6mo,无胆漏、结石残留及胆管狭窄等并发症发生.结论:腹腔镜联合胆道镜应用于胆总管探查是安全的,临床治疗效果良好,具有微创、并发症少等优点,值得临床推广.
AIM：To explore the value of laparoscopy combined with choledochoscopy in the treatment of common bile duct stones. METHODS：The clinical data for 107 patients with choledochlithiasis who underwent laparoscopic common bile duct exploration and stone removal with choledochosopy from April 2008 to March 2011 at our hospital was retrospectively analyzed to explore their therapeutic value. RESULTS：Of 107 patients, 102 had successful laparoscopy and choledochoscopy, and 5 underwent a conversion to laparotomy. Total operative time was 120-150 min （average 140 min）. Blood loss was 20-80 mL （average 55 mL）. Postoperative hospitalization length was 7-15 d （average 8. 5 d）. Peritoneal drainage tubes were placed in 83 cases; 16 cases only had little pale yellow drainage fluid on the first postoperative day, and their tubes were removed on the fourth postoperative day after no fluid was drained for 3 d. About 300 mL of fluid was drained on the first postoperative day in the remaining patients, and their tubes were removed on the sixth postoperative day after no fluid was drained for 4 d. T-tubes were removed 4 wk postoperatively. All of the patients recovered well and were followed up for 3 to 6 months. No patients developed bile leakage, residual stones, or bile duct stricture. CONCLUSION：Laparoscopy combined with choledochoscopy has good efficacy and fewer complications and is less invasive in the management of common bile duct stones.
出处
《世界华人消化杂志》
CAS
北大核心
2012年第26期2496-2499,共4页
World Chinese Journal of Digestology
关键词
腹腔镜
胆道镜
胆总管结石
Laparoscopy
Choledochoscopy
Common bile duct stones
