摘要
目的研究胆道镜、腹腔镜、十二指肠镜术中联合治疗胆囊结石合并胆总管结石的方法及临床意义。方法用腹腔镜联合术中胆道镜、十二指肠镜治疗胆囊结石并发胆总管结石100例,在全麻下,行腹腔镜胆囊切除,并切开胆总管前壁,以术中胆道镜联合十二指肠镜取净胆总管结石,一期缝合胆总管,97例置鼻胆管引流。3例因术中十二指肠镜进镜失败而置入胆道支架。结果本组100例病例4例中转开腹手术,96例成功,术后5～7d拔管出院,3例术后7天内镜取出支架出院,无手术死亡病例,无术后胆漏,无术后上消化道出血、穿孔及急性胰腺炎发生。结论腹腔镜联合术中胆道镜、十二指肠镜治疗胆囊结石并发胆总管结石,是一种创伤小,恢复快,减少病员痛苦,安全可靠的方法。
Objective To investigate the method and it＇s clinical significance that treat the common bile duct stone by ＂tri--scope＂： laparoscope combine with cholioscope and duodenoscope used in opera- tion. Methods Treat the common bile duct stone by laparoscope combine with cholioscope and duodeno scope used in operation 100cases. Under general anesthesi, laparocystectomy was performed first, then open the anterior wall of common bile duct（CBD）, exposed CBD by cholioscope and took off the stones by cholioscope combined with duodenoscope. Then suture the CBD in operation and put in nose bile duct 97 cases, 3 cases put in bracket. Results 4 cases turned to open operation. 96of 100 cases acquitted suc- ceeded and leaft hospital after taking off the nose bile duct in 5 to 7 days. 3 cases took off the bracket by duodenoscope after 7 days. No case died, no bile leaking after operation, no bleeding and perforation of upper digestive tract, and no acute pancreatitis after operation. Conclusions Treat ing the common bile duct stone by laparoscope combine with cholioscope and duodenoscope used in operation is a safe ,effec- tive, and quickly recovering method with less sufferings of the patient and less trauma.
出处
《齐齐哈尔医学院学报》
2012年第20期2758-2759,共2页
Journal of Qiqihar Medical University
