腹腔镜联合胆道镜胆总管探查取石术的临床应用

Clinical application of laparoscopy combined with choledochoscopy for common bile duct exploration and calculus removal

目的探讨腹腔镜联合胆道镜胆总管探查取石术的临床应用价值。方法对我院2002年2月～2008年2月行腹腔镜联合胆道镜胆总管探查取石的胆总管结石58例的临床资料进行回顾性分析。结果本组行胆总管切开取石后T管引流45例,取石后一期缝合胆总管壁5例,经胆囊管行胆总管胆道镜探查取石8例。术后残留结石2例,采用胆道镜通过T管窦道取出结石;胆漏1例。结论腹腔镜联合胆道镜探查取石术创伤小、恢复快、手术安全,可达到良好的治疗效果。

Objective To explore the clinical use of laparoscopy combined with choledochoscopy for common bile duct exploration and calculus removal. Methods The clinical data of 58 patients undergoing laparoscopic common bile duct exploration combined with choledochoscopy from February 2002 to February 2008 were analyzed retrospectively. Results The procedure was successful in 45 cases with T tube drainage and 5 cases with primary suture of duct incision,and 8 cases were subjected to laparoscopic transcystic common bile duct exploration. Residual stones of 2 cases were removed by choledochoscopy postoperatively. Bile leakage occurred in one case. Conclusion Laparoscopy combined with choledochoscopy for common bile duct exploration and calculus removal is safe and microinvasive, and therapeutic effectiveness in treating calculus of bile duct was satisfactory.