三镜联合治疗胆总管结石合并胆囊结石的体会(附34例报告)

Combined three endoscopes in treating choledocholithiasis with cholecystolithiasis:with a report of 34 cases

目的:探讨三镜联合治疗胆总管结石合并胆囊结石的手术方法及疗效。方法:回顾分析2006年1月至2008年6月,我院应用腹腔镜、胆道镜、十二指肠镜联合治疗34例胆总管结石合并胆囊结石患者的临床资料。结果:34例手术均获成功,无中转开腹及死亡病例;三镜联合累计手术时间90～245min,平均130min,术中出血20～180ml,平均70ml,术后住院7～15d,平均9.3d;随访6～24个月,平均11.3个月,无结石复发及严重并发症发生。结论:三镜联合冶疗胆总管结石合并胆囊结石具有创伤小、功能恢复快及结石除净率高等优点。

Objective： To explore techniques and effects of combined three endoscopes on treating choledocholithiasis with cholecystolithiasis. Methods ： The clinical data of 34 patients with choledocholithiasis and eholeeystolithiasis that were treated with laparoscopy, eholedochoscopy and duodenoseopy from Jan. 2006 to Jun. 2008 in our hospital were collected and analyzed retrospectively. Results：All operations were successfully performed. Nobody was converted to open surgery and no fatalities were noted. Stones were completely removed during the operation in all patients. The operation time was 90-245min （ average 130min）. The volume of blood loss in operation was 20-180ml （average 70ml）. The postoperative hospitalization was 7-15d （average 9.3d）. Follow-up observations in all 34 patients for 6-24 months （ average 11.3 months） found no recurrence of bile duct stones or serious further complications. Conclusions： Laparoseopy, eholedoehoscopy combined with duodenoseopy for choledoeholithiasis with cholecystolithiasis have the advantage of less invasion,rapid recovery and is a safe and effective method for choledocholithiasis with eholecystolithiasis.