腹腔镜下胆道镜探查取石术在高龄患者中的应用

Choledochoscopic exploration and cholelithotomy in laparoscopy for aged patients

目的:探讨腹腔镜联合胆道镜治疗高龄胆总管结石致梗阻性胆管炎患者的应用价值。方法:为27例胆总管结石并胆道梗阻的高龄患者施行腹腔镜联合胆道镜胆囊切除、胆总管切开取石、"T"管引流术。结果:27例患者均一次性取石成功,无中转开腹,出院后1个月彩超检查示无残石。结论:腹腔镜胆道镜联合应用具有患者创伤小、康复快等优点;丰富的临床经验和熟练的镜下操作技术是手术成功的关键。

Objective：To investigate the application value of laparoscopy combined with choledochoscopy in treatment of aged patients with obstructive cholangitis caused by choledocholithiasis.Methods：The 27 aged patients who suffered from choledocholithiasis and bile duct obstruction were performed laparoscopic cholecystectomy,choledocholithotomy and T-tube drainage with combination of choledochoscopy.Results：The calculi in all patients were removed at one time,without conversion to laparotomy.No residual stones were found by color ultrasonography after one month.Conclusions：Laparoscopy combined with choledochoscopy has advantages of mini-invasion and quick recovery.Rich clinical experience and skilled laparoscopic-choledochoscopic manipulation are essential for the success of operation.