中斜切口联合胆道镜在低创胆总管探查中的临床应用

Clinical application of medium oblique incision combined with choledochofiberoscope in less-invasive common bile duct exploration

目的探讨中斜切口行纤维胆道镜胆总管探查不置T管低创化手术的可行性。方法中斜切口经胆囊管胆道镜探查网篮取石21例,胆道镜胆总管探查一期缝合32例,均不置T管引流。结果 53例均获得满意的低创效果,无严重并发症,无一例结石残留及胆道梗阻发生。结论遵守严把适应证的原则,中斜切口胆道镜胆总管探查一期缝合胆总管,不置T管引流是低创、安全、可行的。

Objective To evaluate the feasibility of applying choledochofiberoseope without T-tube drainagein less-invasive common bile duct exploration. Methods Twenty-one cases with biliary diseases underwentmedium oblique incision via cystic duct for stone removal with choledochofiberoscope and grasping basket,and 32 cases got primary bile duct suture after bile duct exploration. T-tube drainage was not used in allcases. Results Less-invasiveness was satisfactorily obtained in 53 cases, no severe complication occurred,and no residual stones and bile duct stricture were found. Conclusion Without T-tube drainage, applicationof medium oblique incision combined with choledochofiberoscope is definitely valuable in achieving less-invasive operation for biliary diseases and primary suture of bile duct is proved safe and feasible. Its indicationmust be abided.