腹腔镜手术治疗胆道结石57例临床分析

Clinical experience in laparoscopic management of choledocholithiasis

目的探讨腹腔镜胆总管探查术(LCBDE)治疗胆道结石的临床疗效。方法回顾性分析我们自2003年1月～2006年1月行腹腔镜胆总管探查术治疗胆道结石57例的临床资料。结果行腹腔镜下胆道镜经胆囊管、胆总管探查术21例,顺利完成15例,转为腹腔镜胆总管切开探查术6例。行腹腔镜胆总管切开探查术42例,中转开腹2例;发生胆漏3例,经腹腔引流后自愈;术后残余结石4例,经窦道取石后取尽。术后随访43例,随访时间3～12个月,未发现残余结石及胆管狭窄。结论LCBDE是一种治疗胆道结石安全、有效、微创和可行的方法。

Objective To evaluate the clinical effects of laparoscopic common bile duct exploration（LCBDE）for cholelithiasis. Methods A retrospective review was performed on 57 cases of gallbladder disease with calculus of bile duct from January 2003 to January 2006 using laparoscopic choledoehotomy. Results Among 21 cases of laparoscopic transcystic common bile duct exploration, 15 patients were completed successfully, and 6 patients converted to laparoscopic choledochotomy. Laparotomy were converted in 2 patients, and bile leakage occurred in 3 cases who were cured by abdominal drainage in 42 cases subject to laparoscopic eholedoehotomy. Four patients had postoperative residual gallstone of biliary tract which was removed by biliary tract endoscope though sinus. Forty-three cases were followed-up from 3-12 months. No residual stone or biliary tract stenosis were found. Conclusion LCBDE is a safe, effective, minimally invasive and feasible option for eholelithiasis.