腹腔镜胆总管切开取石术治疗细径胆总管结石

Laparoscopic choledocholithotomy for thin choledochus.

目的总结运用腹腔镜胆总管切开取石术治疗细径胆总管结石的治疗经验。方法1993年10月至2005年3月运用腹腔镜胆总管切开取石术(包括胆总管切开,胆管镜取石,经胆囊管残端输尿管导管胆管引流、T管引流、胆总管切口即时缝合等)有选择地对87例胆总管内径≤0.8 cm的胆总管结石病人进行治疗。结果87例腹腔镜胆总管切开取石均手术成功,无中转开腹及术后残余结石。术后5例出现胆漏,均经术中常规放置的胆管引流和腹腔引流管引流治愈。术后经输尿管导管胆管造影见胆总管切口缝合区狭窄2例(未处理),无其他严重并发症,无死亡。结论只要选择合适的病例,腹腔镜胆总管切开取石术治疗细径胆总管结石是可行、有效和安全的。

Objective To summarize the experience of Laparoscopic choledocholithotomy for thin choledochus. Methods From October 1993 to March 2005 ,there were 87 cases undergoing the operation. Main methods included choledochotomy, eholedochoscopic exploration, ureteral catheter through cystic duct remnant for drainage of bile duct, T-tube drainage, and the primary closure of duct incision. Results The operation was successful in 87 cases. None of them were shifted to open common bile duct exploration. No one had residual stones. Bile leakage was cured by drainage in 5 cases. Two patients had bile duct stenosis of primary closure of duct incision. No one died postoperatively. Conclusion If patients are suitable,laparoscopic choledocholithotomy is safe and effective in the hands of skilled endoscopiests.