摘要
目前,对腹腔镜胆囊切除术(LC)后胆管残石及腹腔镜胆道探查术(LCDE)后胆管再生结石的处理,多采用经内镜乳头切开(ES)或者开腹胆道探查(OCDE)。我院从1997年6月到1999年2月,对5例LC术后胆管残石和2例LCDE术后胆管再生石,选用再次LCDE处理。两次手术间隔1天到5年。术中一次取净结石。2例术后安置T管,5例胆管一期缝合。T管于术后6周拔除,并经T管窦道行胆道镜检查。胆管一期缝合者,术后3月行静脉胆道造影(IVC),均未发现残石和狭窄。结论:腹腔镜手术的微创优越性,使再次腹腔镜手术处理胆管残石和再生石成为可能。
Postoperative endoscopic sphincterotomy (ES) and open common bile duct exploration (OCDE)
are commonly used to remove retained/ recurrent common bile duct stones (CBDS) after
laparoscopic cholecystectomy (LC) or laparoscopic common bile duct exploration (LCDE). With
the development of laparoscopic experience, reoperation of LCDE similar to open procedure is
a new attractive option to select for retained/recurrent CBDS after laparoscopic biliary
operations. Between June 1997 and February 1999, Five patients with retained CBDS after LC
and 2 patients with recurrent CBDS after LCDE were demonstrated at ERC. The two admissions
were between 1 day to 5 years. There were 5 men and 2 women with median age of 51 years
(rang 15 to 77 years). Clearance of bile duct was complete in all 7 patients (100%) by means of
reoperation of LCDE. 2 patients with T-tube insertion, T-tubes were extracted 6 weeks after
LCDE and followed choledochoscopy down the T-tube track. Five patients had primary duct
closure after the bile duct being cleared. Intravenous cholangiography (IVC), 3 months after
LCDE, proved that there were no signs of retained CBDS or bile duct stricture. There was only
one mild complication of port site infection . In conclusion, we believe that retained/ recurrent
CBDS after LC or LCDE can be managed by reoperation of LCDE safely, effectively in expert
hands.
出处
《华西医学》
CAS
1999年第2期149-150,共2页
West China Medical Journal
关键词
胆管残石
再生结石
胆结石
再手术
retained/recurrent bile duct stone,reoperation/laparoscopic common bile duct
exploration