扩张导管技术在腹腔镜胆总管探查术中的应用价值

<title>lue of catheter dilatation in laparoscopic common bile duct exploration

目的 探讨扩张导管技术在腹腔镜胆总管探查术中处理胆总管下端狭窄或结石梗阻的应用价值。方法 腹腔镜胆总管探查术中,采用扩张导管和斑马导丝对胆总管下端膜状狭窄或结石梗阻部位进行扩张。结果 扩张膜状狭窄43例均获成功。扩张胆总管下端结石梗阻16例成功13例。胆漏2例经术中常规放置的腹腔引流管引流自愈,残石3例经术中放置的T管引流术后2个月胆道镜取出。无中转开腹、肠穿孔、胆管穿孔、胆管大出血、胰腺炎,无死亡。结论 选择合适病人,扩张导管技术在腹腔镜胆总管探查术中处理胆总管下端膜状狭窄或结石梗阻有效、安全、可行。

<abstract>jective To investigate the role of catheter dilatation in treating the terminal cho-ledochiarctia and choledocholith obstruction in laparoscopic common bile duct exploratioa Methods During laparoscopic common bile duct, the dilatable catheter and zebra guidewire were used to dilate the terminal membraniform choedochiarctia and choledocholith obstruction. Results The expected goal was achieved in all the 43 patients with terminal membraniform choledochiarctia. For the 16 patients with terminal choledocholith obstruction, successful duct clearance was realized in 13. Two patients with bile leakage were cured by placing drainage tube. In the 3 patients with residual stones, T tube was placed and the tubes were taken out with choledochoscopy 2 months later. There were no conversion to laparotomy, perforation of intestine and bile duct, bleeding, pancreatitis and death. Conclusions This method of catheter dilatation is feasible, safe and simple.