腹腔镜联合胆道镜治疗老年胆管疾病(附162例报告)

Laparoscopic Treatment Combined with Choledochoscopy for Bile Duct Disease in Elderly Patients:Report of 162 Cases

目的总结腹腔镜联合胆道镜治疗162例老年胆管疾病的经验。方法腹腔镜胆总管切开、胆道镜探查取石、一期缝合胆管或T管引流术(LCDE)。结果161例LCDE患者中92例行一期缝合术、69例行T管引流术,1例中转开腹。术后胆漏11例,2例术后发现其他病变而择期另行开腹手术,死亡1例。结论做好充分术前准备后,腹腔镜联合胆道镜治疗老年人胆管疾病是安全、微创的,特别是一期缝合术,但要严格手术适应证。

Objective： To conclude the experiences of laparoscopic treatment combined with choledochoscopy for bile duct diseasein 162 elderly patients. Methods： Laparoscopic CBD exploration （LCDE） and primary bile duct suture or T tube drainage. Results： 161 patients were operated by LCDE, and 1 patient was exchanged to open abdominal operation. After operation 11 patients leaked the bile juice, and 2 patients suffered open abdominal operation for discovering other bile duct disease later. 1 patient died. Conclusion： With sufficient preparation before operation, laparoscopy combined with choledochoseopy was technically feasible and minimal invasive treatment for bile duct disease in 162 elderly patients, especiallyprimary bile duct suture. But the operation indications must be strict.