老年肝内外胆管结石的腹腔镜手术治疗

Laparoscopic surgery for calculi in intrahepatic and extrahepatic duct

目的 :探讨老年肝内外胆管结石行腹腔镜手术的可行性、特点及围手术期处理。方法 :应用腹腔镜胆总管切开纤维胆道镜取石治疗老年性肝内外胆管结石 2 0例 ,显露肝门 ,切开胆总管 ,取石 ,胆总管均放置T形管引流。结果 :2 0例手术均获成功 ,1例术后肝内胆管残余结石 ,术后 6周经T管窦道纤维胆道镜取石治愈。 1例 16d拔T管后胆汁性腹膜炎 ,开腹引流治愈。结论 :老年性肝内外胆管结石腹腔镜手术 ,患者创伤小 ,安全 ,疗效满意。

Objective:To discuss the feasibility,characteristic and perioperative management in laparoscopic op-eration for calculi in intrahepatic and extrahepatic duct in senile patients.Methods:20patients were exposed porta hepa-tis,opened common bile duct,removed calculi,and put T tube drainage by laparoscopy.Results:All cases obtained suc-cessful results;1case had left calculus,Which was removed through the sinus of Ttube sixweeks later;1case had biliary peritonitis when T tube was pulled out on sixteen day after the operation,and was cured by laparotomy to drainage.Con-clusions:Laparoscopic operation for bile duct calculi in senile pationts is a safe,minimal traumatic and effect method.