摘要
目的 :探讨十二指肠镜乳头括约肌切开术 (EST)联合腹腔镜胆囊切除术 (L C)治疗胆囊胆总管结石的治疗方法和效果。方法 :对 45例病人常规行 ERCP,发现胆管结石后 ,即时或择期行 EST。 45例中立即取石或碎石者 36例 ,择期取石 9例 ,有 3例术后自行排出结石。各例常规行鼻胆管引流术 (ENBD)。 1～ 2周后再行 L C。结果 :全组病例 EST均获成功 (10 0 % ) ;结石排净 42例 (93.5 % ) ;行 L C成功 39例 ,中转开腹手术 3例 (7.1% )。L C术后 3～ 5天出院。发生并发症 6例 (13.3% ) ,表现为轻症胰腺炎 ,乳头切开后出血 ,均经保守治疗痊愈。结论 :EST联合 L C治疗胆囊胆总管结石是一种可供选择的微创治疗方法 ,扩大了 L C的指征 ,具有创伤小、效果好、并发症少、恢复快等优点 。
Objective:To evaluate the effects of combined endoscopic sphincterotomy(EST) and laparoscopic cholcystectomy(LC) on patients with cholecystocholedocholithiasis.Methods:EST or EPT was performed in forty five gallstone patients with concomitant cholelithiasis diagnosed by routine endoscopic retrograde cholangiopancreatography(ERCP) immediately or seletively.Endoscopic nose biliary drainage(ENBD) was performed routinely. LC was performed one to two weeks later.Results:EST or EPT was successfully performed in all patients. Stones in common bile duct were completely extracted in 42 patients. LC was successfully performed in thirty nine of 42 patients. 3(7.1%) of 42 patients treated by LC turned to open cholecystectomy immediately. The LC patients were discharged 3～5 days after operation. Complications occurred in 6(13.3%) patients who were successfully treated medically.Conclusion:The operation Combining EST and LC may be a choice of effective therapeutic method for cholecystocholedocholithiasis by enlarging the indications for LC and preserving the merits of the minimally invasive approach such as less injury, good effect,low morbidity, quick recovery and so on.
出处
《肝胆胰外科杂志》
CAS
2000年第4期189-190,共2页
Journal of Hepatopancreatobiliary Surgery
关键词
胆囊结石
胆总管结石
腹腔镜
胆囊切除术
治疗
gallstone
common bile duct stone
laparoscopic cholecystectomy
endoscopic sphincterotD
