腹腔镜下处理胆囊管结石的技术要点探讨

Technique of disposing cholecystic duct calculi through laparoscopy

目的:探讨腹腔镜下处理胆囊管结石的技术要点。方法:回顾分析我院近3年71例胆囊管结石患者的临床资料。主要通过术中器械触探,术后剖检胆囊管将结石连同部分胆囊管切除,必要时修复胆总管缺损。结果:所有患者均在腹腔镜下顺利完成手术。术后恢复顺利,随访3～12个月未发继发胆总管结石和腹痛等。结论:腹腔镜胆囊切除术中应常规探查胆囊管有无结石,避免结石残留。

Objective：To investigate the technique of disposing cholecystic duct calculi through laparoscopy. Methods：The climical data of seventy-one cases undergone laparoscopic cholecystectomy with cystic duct calculi were retrospectively analyzed. The cystic duct calculi were diagnosed by touching of the cystic duct with dissection clamp during operations or checking the cystic duct after the gallbalder was removed. It was tackled by resecting the cystic duct within the calculi. Openning part of the cystic duct to remove the calculis, and repairing the common bile duct when necessary. Results：All patients were operated successfully by laparoscopy and recovered uneventfully. No secondary common bile duct calculis or abdominal pain were found after 3-12 months follow-up. Conclusions： During laparoscopic cholecystectomy, it should be a routine practice to make sure whether there are calculi in cystic duct and avoid leaving the calculi in the stump of cystic duct.