十二指肠镜和腹腔镜联合治疗胆囊结石合并胆总管结石

Management of Cholecystocholedocholithiasis with duoendoscope and laparoscope

目的总结联合应用十二指肠镜及腹腔镜治疗胆囊结石合并胆总管结石的临床经验。方法选择66例胆囊结石合并胆总管结石患者,先在十二指肠镜下行Oddi括约肌切开取石,之后行腹腔镜胆囊切除,统计两镜联合治疗成功情况、并发症及住院时间。结果64例成功地在十二指肠镜下取出胆总管结石,11例患者术后出现血淀粉酶升高,经抑酶治疗3～5d后均恢复正常,无其他并发症,之后均成功地在全身麻醉下实施了腹腔镜胆囊切除术,无1例发生并发症,住院时间8～17d,平均12.3d。另2例因十二指肠镜下取石失败而改开腹手术。结论两镜联合治疗胆囊结石合并胆总管结石是一种有效、安全和可靠的治疗模式。

[Objection] To summarize the clinical experience of Management of Cholecystocholedocholithiasis with duoendoscope and laparoscope. [Methods] 66 patients with Cholecystocholedocholithiasis were selected. First, endoscopic sphincterotomy was performed to remove the choledocholith. Then laparoscopic cholecystectomy was performed later. The total outcome, complications and the days of hospital stay were summarized. [Results] The choledocholith was successfully removed with duodenoscope in 64 patients. The hemodiastase increased in 11 patients after operation and decreased to normal level 3 to 5 days after inhibition treatment. There were no other complications. Then laparoscopic cholecystectomy was performed successfully in all 64 patients without any complication. The hospital stay ranged from 8 to 17 days, mean 12.3 days. The other two patients was performed by open operation because of failing to remove the stone with duoendoscope. [Conclusion] Management of Cholecystocholedocholithiasis with duoendoscope and laparoscope is an effective, safe and reliable method.