腹腔镜胆囊切除及胆总管探查一期缝合治疗胆囊结石合并胆总管结石(附46例报告)

laparoscopic cholecystectomy plus laparoscopic common bile duct exploration with primary closure in the treatment of cholecysto-choledocholithiasis:report of 46 cases.

目的探讨腹腔镜胆囊切除及胆总管探查一期缝合治疗胆囊结石合并胆总管结石的临床应用价值。方法回顾性分析2006年1月至2009年12月间腹腔镜胆囊切除及胆总管探查一期缝合术46例患者的临床资料。结果所有手术均顺利完成,手术持续时间为80-220 min,平均150 min,术中出血量10-90 ml,平均50 ml。术后住院时间4-9 d,平均6.5 d。1例术后出现胆漏,1例术后套管针处出血。术后随访2-36个月,未发现黄疸、胆道残留结石和胆道狭窄等并发症。结论只要严格掌握适应证,腹腔镜胆囊切除及胆总管探查一期缝合术是治疗胆囊结石合并胆总管结石的一种可行、安全的方法 。

Objective To analyse the clinical value of laparoscopic cholecystectomy plus laparoscopic common bile duct exploration with primary closure.Methods Forty-six patients who underwent laparoscopic cholecystectomy plus laparoscopic common bile duct exploration with primary closure between January 2006 and December 2009 were retrospectively reviewed.Results All operations succeeded.The operative time was 80～220（mean,150） min,The intraoperative blood loss was 20～90（mean,55） ml.The hospital stay was 4～9（mean,6.5） days.Bile leakage after surgery occurred in 1 case,trocar site bleeding occurred in 1 case（4.3%）.No obstructive jaundice,stenosis and residual stone were founded during 2～36 months of follow-up.Conclusion Laparoscopic cholecystectomy plus laparoscopic common bile duct exploration with primary closure is applicable,efficient,and safe for the treatment of cholecysto-choledocholithiasis with strict indications.