LC结合术中胆道镜治疗胆囊合并胆管结石

Treating cholecystocholedocholithiasis by LC and choledochoscope during operation

目的 探讨腹腔镜胆囊切除术(LC)中应用胆道镜经胆囊管取出胆管结石微创治疗胆囊和胆管结石的有效性。方法 32例胆囊并胆管结石病人在腹腔镜胆囊切除术中,经腹腔镜转换器,应用OlympusP20型纤维胆道镜(直径4.9mm)经切开的胆囊管进入胆总管取出结石。结果 本组32例病人中,胆道镜成功取出胆总管结石病人共30例,失败2例;经胆囊管术中胆道镜法,胆总管取石成功率93.8％(30/32),结石残留率为0.3％(1/30)。除2例患者在取石期间,结石掉入腹腔之外,余无严重并发症。30例平均随访2年未发现结石复发。结论 LC联合胆道镜治疗胆囊合并胆管结石成功率高、安全,明显降低了手术并发症及危险性,缩短了住院时间,是治疗胆囊合并胆管结石理想的微创外科技术。

Objective To study the significance of choledochoscope in the treatment Of biliary tract stones by laparscopic cholecystectomy (LC) . Methods In the operation of LC, intraopertive cholecdochoscope were carried out through the cholecystic duct and bile duct stones were removed by liquidoelectronic lithoclast, balloon dilatation , a basket catheter or washing the biliary tract for 32 patients with cholcystocholedochlithiasis. Results In all patients, we used intraoperative choledochoscope successfully in 30 patients, and 2 fail. Removed stone of successful rate was 93. 8% (30/32) . No severe complication occurred except for 2 cases with stones fall to the abdominal cavity. With follow up average 2 years, no reccurrece was found in 30 cases. Conclusion LC combined with choledochoscope in the treatment of choleeysto choledocholithiasis have a high succeful rate, safety and operative conplications and danger are decreased obviously. The time of hospitalization is shortened. So it is an ideal manimally surgical technigue for treating the Cholecystocholedocholithiasis.