摘要
目的 探讨腹腔镜及选择性辅助小切口行胆管探查治疗胆囊结石合并肝外胆管结石的方法和临床价值。方法 完成腹腔镜胆囊切除后,首选腹腔镜下经胆囊管行胆管探查取石术;失败者辅助小切口行经胆囊管胆管探查术,备选胆总管切开探查。2010年4月至2014年4月共治疗171例胆囊结石合并肝外胆管结石。结果 成功完成腹腔镜下经胆囊管胆管探查术95例,其余76例辅助小切口行胆管探查。辅助小切口手术组中,51例经胆囊管行胆管探查;25例行胆总管切开探查（切开探查后Ⅰ期缝合13例,置T管引流12例）。171例中经胆囊管胆管探查成功率为85.4%,并发症3例（1.8%）。随访3~42个月,未发现胆管狭窄。结论 腹腔镜及选择性辅助小切口行胆管探查治疗胆囊结石合并肝外胆管结石疗效好,具有创伤小、恢复快及并发症少等特点。
Objective To evaluate the method for perfoming the common bile duct exploration by laparoscopy and selective assisted small incision in treating cholecystolithiasis complicating extrahepatic bile duct stone and its clinical value. Methods 171 patients diagnosed as cholecystolithiasis complicating extrahepatic bile duct stone in our hospital from April 2010 to April 2014 were enrolled in this study. After completing the laparoscopic cholecystectomy,laparoscopic transcystic common bile duct exploration （LTCBDE） was preferred; assisted small incision transcystie common bile duct exploration was chosen after LTCBDE was failed,and chodochoctomy was an alternative approach. Results 95 cases were successfully treated by LTCBDE and the other 76 cases were performed common bile duct exploration the by assisted small incision. In the small incision group, 51 cases underwent the transcystic common bile duct exploration and 25 cases underwent choledochotomy approach： 13 cases of primary closure and the other 12 cases of T-tube drainage. Among all the cases,the success rate of transcystic approach exploration was 85.4% （146/171） and the complications occurred in 3 cases （1.8%）. All the cases were followed up for 3 --42 months and no bile duct stegnosis was found. Conclusion Perfoming the common bile duct exploration by laparoscopy and selective assisted small incision is an effective method for treating choleeystolithiasis complicating extrahepatic bile duct stone and has the advantages of small trauma, rapid recovery and less complications.
出处
《重庆医学》
CAS
北大核心
2015年第13期1807-1808,1811,共3页
Chongqing medicine
关键词
胆结石
腹腔镜
辅助小切口
cholelithiasis
haparoscopes
assisted small incision
