腹腔镜联合胆道镜治疗胆总管结石的临床疗效及护理体会

Laparoscopic treatment of common bile duct stonesand clinical nursing

目的探讨腹腔镜联合胆道镜在胆总管结石中的治疗效果及护理体会。方法对漯河市中心医院2008年9月至2010年9月采用腹腔镜和胆道镜联合治疗和护理的60例胆囊结石合并胆总管结石或胆总管扩张(直径≥0.8cm)患者的临床资料进行回顾性分析。结果本组60例病例均顺利完成手术,均未中转开腹,手术时间50～160min,术中出血量50～450ml。所有病例均恢复良好,未出现腹腔感染、胆道出血或近期胆管狭窄等并发症。仅1例术后出现胆漏,经延长腹腔引流管留置时间后胆漏自行停止,痊愈出院。结论腹腔镜下胆总管切开、胆道镜取石、胆总管一期缝合是安全、有效的手术,该术式具有创伤小、痛苦少、恢复快、并发症少等优点,同时要加强手术前的心理护理、相关并发症的观察及护理,对提高疗效有重要作用。

Objeetive To evaluate laparoscopic common bile duct stones in the biliary mirror effect in the treatment and nursing.Methods The hospital from September 2008 to September 2010 during the use of laparoscopic and endoscopic treatment of biliary and care of 60 cases of gallbladder stone with common bile duct stones or common bile duct dilation（diameter≥0.8cm） clinical data retrospective analysis.Results 60 cases were successfully operated,were converted to laparotomy,operative time was 50～160min blood loss 50～450ml.All patients recovered well,does not appear abdominal infection,biliary duct stenosis or recent bleeding complications.Only 1 case of postoperative bile leakage,intra-abdominal drainage tube indwelling the extended time on their own bile leakage stopped,discharged.Conclusions Laparoscopic common bile duct,bile duct stone mirror,common bile duct suture is safe and effective surgery,the surgical procedures with less trauma,less pain,faster recovery,fewer complications,and to strengthen the pre-operative psychological care,observation and care-related complications,to improve the efficac plays an important role.