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腹腔镜经胆囊管取石及胆囊切除治疗妊娠期胆总管结石 被引量:9

Management of choledocholithiasis during pregnancy by laparoscopic transcystic common bile duct stone extraction and cholecystectomy
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摘要 目的探讨同期免T管腹腔镜经胆囊管探查取石术及胆囊切除术治疗妊娠继发胆总管结石的可行性及安全性。方法回顾分析4例腹腔镜下经胆囊管探查取石术及胆囊切除术治疗妊娠继发胆总管结石患者的临床资料。结果4例患者均因急性胆管炎入院,处于妊娠中期,术前磁共振胰胆管成像显示胆总管内结石直径均小于胆囊管直径,其中3例患者胆囊内多发小结石。4例患者均顺利完成腹腔镜经胆囊管胆总管探查取石及胆囊切除术。手术时长88~150min,出血10~50ml,住院时间4~12d,术后均无外科并发症并顺利分娩,随访亦无胆总管结石复发。结论同期免T管腹腔镜经胆囊管探查取石及胆囊切除术治疗妊娠继发胆总管结石安全可行。 Objective To explore the feasibility and safety of laparoscopic transcystic common bile duct stone extraction and cholecystectomy in pregnant patients with choledocholithiasis. Methods A retrospective analysis of 4 pregnant patients with choledocholithiasis was performed.The clinicoradiologic,perioperative and follow up data were analyzed. Results The 4 patients were admitted for acute cholangitis at their second trimester of pregnancy.Preoperative MRCP demonstrated that the diameter of the common bile duct stone was less than that of the cystic duct.Laparoscopic transcystic common bile duct stone extraction and cholecystectomy were successfully conducted.Plasma shock wave lithotripsy was applied in one patient with impacted gallstone,intraoperative cholangiography was conducted in one patient with suspected residual stone.There was not major post-op complications nor stone recurrence in the follow up postoperatively.They all delivered a healthy baby on the expected date of childbirth. Conclusions Simutaneously laparoscopic transcystic common bile duct stone extraction and cholecystectomy in pregnant patients with choledocholithiasis is feasible and safe.
作者 张铃福 侯纯升 王立新 凌晓锋 王港 崔龙 徐智 修典荣 Zhang Lingfu;Hou Chunsheng;Wang Lixin;Ling Xiaofeng;Wang Gang;Cui Long;Xu Zhi;Xiu Dianrong(Department of General Surgery,Peking University Third Hospital,Beijing 100191,China)
出处 《中华普通外科杂志》 CSCD 北大核心 2019年第2期136-138,共3页 Chinese Journal of General Surgery
关键词 妊娠 胆总管结石 腹腔镜 Pregnancy Choledocholithiasis Laparoscopes
作者简介 通信作者:侯纯升,Email:chunshenghou@126.com,电话:010-82267332.
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