摘要
目的 探讨腹腔镜治疗肝内外胆管结石的方法。方法 将胆总管切开至左右肝管汇合部 ,使左右肝管的开口得到很好显露 ,在腹腔镜的监视下 ,将左右肝管内结石取出 ,进而利用扩张的左右肝管 ,显露各二级胆管的开口 ,取出二级胆管结石 ,在二级胆管明显扩张时 ,还可以看到三级胆管内的结石 ,并将其取出。存在较多泥沙样结石时 ,可用导尿管反复冲洗胆道。结果 本组 4 7例 ,手术时间 75～ 2 70min ,平均 (130±5 7.4 )min ,32例病人术后仍有残石 ,需要胆道镜取石。中转开腹 3例。 2例胆总管下端结石嵌顿的病人 ,通过腹腔镜下术中液电碎石后将结石取出。结论 腹腔镜下高位胆管切开可以较好地显露一、二级胆管 ,甚至三级胆管 。
Objective: Discuss the methods of treatment of cholelithiasis with laparoscope.Methods: High choledochotomy was performed so that we can show right or left bile duct. The secondary duct can be demonstrated through the dilated primary bile duct. Sometimes even tertiary duct can be seen.Results:There are 47 patients in this group. Time of operation was 75～270 minutes, average (130±57.4) minutes. In 32 patients some stones remained in the bile duct, which were cleared up by choledochoscope. There were three cases converted to open surgery.Conclusions:Laparoscopic high choledochotomy can show right or left bile duct. The secondary, even tertiary bile duct can be demonstrated through dilated primary duct.
出处
《中国内镜杂志》
CSCD
2003年第11期13-15,共3页
China Journal of Endoscopy
关键词
腹腔镜
高位胆管切开
胆道结石
Laparoscope
High Choledocholithotomy
Cholehthiasis
