摘要
目的 评价腹腔镜胆总管探查的临床价值。 方法 1992年 3月～ 2 0 0 1年 5月无选择经随访后的腹腔镜胆总管探查 5 30例 ,其中置T管 2 2 2例 ,术后 2月拔T管 ,并常规作胆道镜检 ;胆管I期缝合 30 2例 ,术后 3月作静脉胆道造影或B超随访 ;经胆囊管探查 6例。 结果 中转开腹率 0 4 % ( 2 / 5 30 )。胆管阴性探查率 4 0 % ( 2 1/ 5 30 )。术中结石取净率 85 3 %( 434/ 5 0 9)。胆管再生结石率 0 8% ( 4/ 5 30 )。手术并发症率 13 6 % ( 72 / 5 30 ) ,死亡率 0 4 % ( 2 / 5 30 )。 5 30例随访 ( 3 5± 0 3)年 ,无胆管狭窄。 结论 腹腔镜胆总管探查创伤小、并发症率和死亡率低 ,半数以上可作胆管I期缝合。
Objective To evaluate the clinical value of laparoscopic common bile duct exploration (LCDE). Methods LCDE was completed in 530 cases, with follow-up between March 1992 and May 2001 in this hospital. T-tube drainages were performed in 222 cases and T-tubes were removed 2 months postoperatively, followed by routine choledochoscopy to ensure the bile duct free of stones; primary bile duct sutures were performed in 302 cases, followed by intravenous cholangiography (IVC) or ultrasonogram 3 months postoperatively.The common bile ducts of other 6 cases were explored through cystic duct. Results Conversions to open operations were required in 2 cases (0.4%). There were 21 explorations with negative results (4.0%). Stones were removed completely in 434 cases (85.3%). Complications were found in 72 cases (13.6%). Mortality 0.4%. None of 530 cases was found postoperative bile duct stricture in follow-up (3.5±0.3 years). Conclusions LCDE is growing up as a safe and effective approach with minimal invasion, fewer complications and low mortality for patients with choledocholithiasis, and primary duct suture could be performed in more than half cases.
出处
《中国微创外科杂志》
CSCD
2003年第2期122-124,共3页
Chinese Journal of Minimally Invasive Surgery
