腹腔镜联合胆道镜经胆囊管胆总管探查取石术的体会

The Experience of Exploration for Stone Exclusion by Peritoneoscope Combined with Cholangioscopy via the Cystic Duct and Common Bile Duct

目的探讨腹腔镜联合胆道镜经胆囊管胆总管探查取石的临床应用价值。方法回顾性分析2009年1月至2011年2月在我院开展的腹腔镜联合胆道镜经胆囊管胆总管探查取石术18例患者的临床资料。结果成功取出结石14例,中转开腹3例,胆道探查阴性1例,成功率为77.7%,住院时间为4～9天,全部顺利出院,无并发症发生。结论针对适宜病人,用腹腔镜联合胆道镜经胆囊管治疗胆总管继发性结石,利用自然的胆囊管开口达到取石目的 ,避免胆总管切开,保持胆道的完整性和正常生理功能,具有创伤小、并发症少、费用低等优点,具有较重要的临床推广价值。

Objective To explore the clinical application value of exploration for stone exclusion by peritoneoscope combined with cholangioscopy via the cystic duct and common bile duct.Methods The clinical data of 18 patients with exploration for stone exclusion by peritoneoscope combined with cholangioscopy via the cystic duct and common bile duct in our hospital from January 2009 to February 2011 were retrospectively analyzed.Results The stones of 14 cases were successfully removed,3 cases were given the laparotomy,the bile duct exploration of one case was negative,the success ratio was 77.7%,the hospital stay was 4 ～ 9 d,all the patients were discharged without complications.Conclusion In view of the suitable patients,the peritoneoscope combined with cholangioscopy via the cystic duct for the treatment of secondary stones of common bile duct,which uses the natural cystic duct opening to achieve the purpose of stone exclusion,avoids cutting the common bile duct,maintains the integrity and normal function of bile duct,has the advantages of less trauma,fewer complications,and lower cost and so on,and has the more importantly clinical promotion value.