双镜联合胆总管切开取石方法的分析

Study on appropriate approach of extraction of bile duct stones during the operation of combined laparoscopic and choledochoscopic common bile duct exploration

目的探讨双镜联合胆总管探查术中的取石方法及各种方法的适应证。方法自2004年2月-2005年3月,实施双镜联合胆总管探查术17例,术中根据胆管结石的具体情况,分别或联合应用3种取石方法(水冲法取石、器械直接取石、胆道镜网篮取石)取出胆管中结石。结果17例手术均成功,无中转开腹,均留置T管。结论联合应用3种取石方法,能有效地提高双镜联合胆总管探查术中结石取净率。

Objective To study the most appropriate approach and related indications of extraction bile duct stones during the operation of combined laparoscopic and choledochoscopic common bile duct exploration. Methods From February 2004 to March 2005, 17 cases received the therapeutic procedures. According to the special conditions of bile duct stones, 3 approaches of extraction of bile duct stones were performed, i. e., saline flushing, tools of lapamscopy or laparotomy, choledochoscopic basket manipulation. Results In 17 cases, the operation in 17 cases were successful. 0 cases were converted to laparotomy. 17 cases were converted to T- tube drainage. Conclusion It is proved that ston clearance can be markedly improved by the operation of combined lapamscopic and choledochoscopic common bile duct exploration through the combination of the three methods of stone extraction.