摘要
目的:探讨腹腔镜诊断及处理急性胆囊炎合并胆囊管结石嵌顿的方法。方法:回顾分析自2006年以来收治的53例行腹腔镜诊治的急性胆囊炎合并胆囊管结石嵌顿患者的临床资料,总结处理胆囊管结石的方法。结果:50例腹腔镜下成功取出胆囊管结石,3例中转开腹;49例取出1枚结石,4例取出2枚结石;2例行术中胆道造影,未发现胆总管结石;1例术后出现轻度黄疸,术后第6天黄疸逐渐消退;1例出现胆漏,经保守治疗10 d后痊愈。手术时间平均(75.66±21.27)min;出血量平均(50±13)ml;术后无继发胆总管结石;平均住院(6.92±1.55)d,无死亡病例。结论:胆囊管结石术前明确诊断较困难,术中耐心、细致的操作,可预防术后胆囊管残留结石及继发胆总管结石的发生。
Objective： To investigate the method of laparoscopic diagnosis and treatment of acute cholecystitis complicated with incarcerated cystic duct calculi. Methods： The clinical data of 53 patients who suffered from acute cholecystitis complicated with incarcerated cystic duct calculi and underwent laparoscopic diagnosis and treatment from 2006 were retrospectively analyzed,the treatment methods of cystic duct calculi were summarized. Results： The cystic duct calculi were successfully removed for 50 patients by laparoscopy. 3 patients were converted to laparotomy; 1 calculus was removed for 49 patients,2 calculi were removed for 4 patients; 2 patients were treated with intraoperative cholangiography and no common bile duct stones were found. 1 case of mild jaundice occurred after operation and gradually subsided after 6 d; 1 case of biliary leakage was found and was cured after conservative treatment for 10 d. The operation time was（ 75. 66 ± 21. 27） min and the blood loss was（ 50 ± 13） ml. Postoperative secondary common bile duct stones were not found,hospital stay was（ 6. 92 ± 1. 55） d,no death was found. Conclusions： Preoperative diagnosis of cystic duct calculi is difficult,and most of the cases are diagnosed during operation. Residual calculus of cystic duct and secondary common bile duct calculi can be prevented by the patient and meticulous operation.
作者
栾宁
刁海鑫
张传海
邓青先
马应贤
LUAN Ning DIAO Hai-xin ZHANG Chuan-hai et al(Department of General Surgery, the Third People＇s Hospital of Xining City,Xining 810005, China)
出处
《腹腔镜外科杂志》
2016年第11期850-852,共3页
Journal of Laparoscopic Surgery
关键词
胆囊炎
急性
胆囊管结石
嵌顿
腹腔镜检查
Cholecystitis
acute
Calculus of cystic duct
Incarcerated
Laparoscopy
