腹腔镜胆总管探查术的临床应用

The clinical application of laparoscopic common bile duct exploration

目的：探讨腹腔镜胆总管探查取石术（laparoscopic common bile ductexploration，LCBDE）的临床效果。方法：回顾分析2008年8月至2009年8月我院为20例患者行LCBDE的临床资料。术中联合应用胆道镜、腹腔镜胆道取石钳、可弯取物钳取石。结果：19例顺利完成LCBDE，手术时间90～240min，平均136min，中转开腹1例，无手术并发症发生。住院5-10d，平均7．2d。18例随访2～10个月，无黄疸、胆道结石残留或复发。结论：LCBDE安全、可行，联合应用胆道镜、腹腔镜胆道取石钳、可弯取物钳使取石更加简捷、有效。

Objective：To discuss the clinical effect of laparoscopic common bile duct exploration （LCBDE）. Methods：The clinical data of 20 patients undergoing LCBDE from Aug. 2008 to Aug. 2009 were collected and analyzed retrospectively. The calculi were taken out with choledoehoscopy, laparoscopic bile duct lithotomy forceps and flexible object-catching forceps during operation. Re- suits：The LCBDE was successfully completed in 19 cases and one was converted to open surgery, and no complications were obseryed. The operating time ranged from 90 to 240rain （mean 136rain）. The postoperative hospitalization was 5-10d （mean 7.2d）. Follow-up ob- servations lasted for 2 to 10 months in 18 cases and no jaundice, residual stones in the common bile duct or recurrence were observed. Conclusions：The LCBDE is safe and feasible. It is simpler and more effective to remove calculi with the choledochoscopy, laparoscopic bile duct lithotomy forceps and flexible object-catching forceps.