腹腔镜联合内窥镜治疗胆囊结石合并胆总管结石

Laparoscopy combined with endoscopy in treating cholecystolithiasis and choledocholithiasis

目的探讨应用腹腔镜胆囊切除术(LC)与内窥镜切开oddi括约肌取石术(EST)联合治疗胆囊结石合并胆总管结石的临床效果。方法回顾性分析128例胆囊结石合并胆总管结石患者经逆行胰胆管造影(ERCP),切开Oddi括约肌取石术,网篮取石和气囊排石后,再行腹腔镜胆囊切除术。结果手术成功率94.5%,结石取净率100.0%,无严重并发症。术后住院4-10天。结论LC+EST联合治疗胆囊结石并胆总管结石具有手术创伤小、术后恢复快、并发症少、无需T管引流等优点,是一种安全有效的治疗方法。

Objective To observe the clinicul results of laparoscopic cholecystectonly（LC） combined with endoscopic Oddi sphincterotcmy（EST） in treating cholecystolithiasis and choledocholithiasis. Methods We retrospectively reviewed 128 cases with gallbladderealculi and common bile duct calculi were treated. They were picked out of calculi firstly by ERCP and ESY using endoscope. Then laparoscopic cholecystectomy was carried out. Results The success rate was 95. 0 %, with all the calculi removed completely, no serious complications occurred. The hospitalization after operation was 4 - 10 days. Conclusion Combined LC and EST procedure is a safe and effective method to treat patients suffering from cholecystolithiasis and choledocholithiasis with the advantage of minimal invasion, rapid recovery, less complication and no T tube drainage.