摘要
目的探讨腹腔镜联合纤维胆道镜治疗肝内外胆管结石的方法及效果。方法选择近5年来该院收治的45例肝内外胆管结石患者,于腹腔镜下行胆总管探查+纤维胆道镜取石+T管引流术,有残余结石者术后2月经T管瘘道行纤维胆道镜取石。结果45例手术均获成功,无中转开腹,平均手术时间为(95.0±22.5)min,术中平均失血量为(85.6±16.5)mL,平均住院时间为(7.5±2.6)d,术后并发胆漏2例,腹腔感染1例,均经保守治疗治愈,术后11例胆道残余结石患者经1～3次胆道镜取净。结论腹腔镜联合纤维胆道镜治疗肝内外胆管结石疗效好,创伤小,恢复快,安全可靠,值得应用。
[Objective] To explore the methods and curative effect of laparoscopic and choledochofiberscopic surgeries in the treatment of extra- and intrahepatic cholangiolithiasis. [Methods] Forty-five patients with extra- and intrahepatic cholangiolithiasis, who were hospitalized in our hospital in recent 5 years, were selected for laparoscopic common bile duet exploration, choledochofiberscopic calculi removal and T-tube drainage. The cases with residual calculi in their bile ducts would receive choledoehofiberscopic removal of calculi via T-tube fistula 2 months after the operation. [Results] Laparoscopic and choledochofiberseopic surgeries were performed successfully on 45 patients without transforming to laparotomy. The average operative length was （95.0±22.5） minutes. The average intraoperative blood loss was （85.6±16.5） mL and the average hospital stay was （7.5±2.6） days. Postoperative complications including bile leakage in 2 cases and abdominal cavity infection in 1 were cured through conservative treatment. Residual calculi in 11 patients were cleared by 1 - 3 times choledochofiberscopy. [Conclusion] Laparoscopic and choledochofiberscopic surgeries deserve application in the treatment of extra- and intrabepatic cholangiolithiasis for the advantages such as fine curative effect, tiny trauma, rapid recovery and security.
出处
《中国内镜杂志》
CSCD
北大核心
2009年第6期622-624,共3页
China Journal of Endoscopy
关键词
肝内外胆管结石
腹腔镜胆总管探查
纤维胆道镜检查
extra- and intrahepatic cholangiolithiasis
laparoscopic common bile duct exploration
choledochofiberscopy
