腹腔镜胆总管切开取石T管引流术

Laparoscopic choledocholithotomy with T-tube drainage

目的探讨腹腔镜胆总管切开取石T管引流术治疗胆总管结石的可行性。方法60例胆囊结石合并胆总管结石行腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）、胆总管切开取石T管引流术。结果60例手术均获成功，无中转开腹手术。手术时间90～180min，平均110min；术中出血量10～50ml，平均20ml。2例术后胆漏，保守治愈；6例胆道残余结石术后胆道镜取净。53例（随访率88．3％）随访2～33个月，平均13．2月，均无腹痛，发热，黄疸发作。结论LC、胆总管探查术治疗胆囊结石合并胆总管结石技术可行。

Objective To investigate the feasibility and significance of laparoscopic choledocholithotomy with T-tube drainage. Methods A total of 60 cases of common bile duct stones complicated with gallbladder stones were treated with laparoscopic cholecystectomy and common bile duct exploration with T-tube drainage. Results The operation was performed successfully in all the cases, without conversions to open surgery. Bile leakage occurred in 2 cases and was cured with conservative treatment. Residual stones were found in 6 cases and a postoperative choledochoscopy was required. The operative time was 90～180 min （mean, 110 min）, the blood loss was 10～50 ml （mean, 20 ml）. Follow-up checkups in 53 cases （88.3%） for 2～33 months （mean, 13.2 months） revealed no abdominal pain, fever, or jaundice. Conclusions Laparoscopic cholecystectomy and common bile duct exploration for the treatment of common bile duct stones complicated with gallbladder stones is feasible and minimally invasive.