腹腔镜联合纤维胆道镜胆总管探查82例

Clinical Application of Iaparoscopic Common Bile Duct Exploration Combined with Flexible Choledochoscope in 82 Cases

目的探讨腹腔镜联合纤维胆道镜胆总管探查术的方法及临床应用价值。方法回顾分析我院应用腹腔镜联合纤维胆道镜施胆总管探查取石术82例临床资料。结果82例手术均获成功,胆总管切开取石T管引流术64例,胆总管Ⅰ期缝合18例,平均手术时间110m in,Ⅰ期缝合后胆漏1例,T管引流术后第21天拔T管出现胆漏1例,术后结石残留3例。结论腹腔镜联合纤维胆道镜胆总管探查术治疗肝内外胆管结石是安全、可行的,治疗效果肯定,微创意义明显。

Objective To investigate the methods and clinical value of laparoscopic common bile duct exploration （LCBDE） combined with flexible choledochoscope. Methods The clinical data of 82 cases of common bile duct calculi dealed with laparoscopic common bile duct exploration combined with flexible choledochoscope were analyzed retrospectively. Results Operation on 82 patients with common bile duct calculi was successfully operation. Laparoscopic choledocholithotomy and Ttube drainage （LCHTD） were performed in 64 cases, and primary suture was performed in 18 cases. Th-e average operation duration was 110 min. There was one case of bile leakage after primary suture, and one case of bile leakage after the T - tube was taken away 21days after LCHTD had been done. The residual stones were removed by choledochoscopy in 3 cases postoperatively. Conclusion Laparoscopic common bile duct exploration combined with flexible choledochoscope treating choledochlithiasis is safe and feasible, it has a definite treating effect and a significant minimal invasion.