纤维内镜在腹腔镜胆总管探查术中的应用(附11例报告)

The application of flexible ureteroscope and choledochoscope during laparoscopic common bile duct exploration (a report of 11 cases)

作者对１１例术前或术中诊断胆囊结石伴胆总管结石患者，在腹腔镜下应用纤维输尿管镜经胆囊管探查胆总管取石和胆总管切开用胆道镜探查取石。结果：输尿管镜经胆囊管探查４例，取石２例，阴性１例，改胆总管切开取石１例。腹腔镜下胆总管切开用胆道镜探查取石８例（包括改行１例），阴性１例。放置Ｔ管６例，一期缝合胆总管２例。均治愈。作者认为，腹腔镜下用纤维输尿管镜经胆囊管行胆总管探查取石和胆总管切开用胆道镜探查取石是安全可行的手术方法，明显优于剖腹手术。

Eleven patients with gallstone and choledocholith were treated laparoscopically by either transcystic duct ureteroscopic exploration, which was carried out on 4 patients, with stone removal in 2, negative exploration in 1, and conversion to common bile duct incision in 1; or through common bile duct incision choledochoscopic exploration and stone removal of the common bile duct which was performed on 8 patients with 1 negative common bile duct exploration, T tube was placed in 6 and the common bile duct was sutured by stage Ⅰ in 2. All patients were cured. The authors believe that these two procedures are feasible, safe and preferable to laparotomy.