腹腔镜胆总管切开取石T管引流术

Laparoscopic choledocholithotomy with T-tube drainage

目的:探讨腹腔镜胆总管切开取石T管引流术的临床经验。方法:回顾分析为22例胆囊结石合并胆总管结石患者施行腹腔镜手术的临床资料。术中暂不切除胆囊,先显露胆总管,切开取石,T管引流,最后切除胆囊。结果:22例手术均获成功,无一例中转开腹,手术时间100～180 min,平均120 min;术中出血量5～30 ml,平均10 ml;术后住院8～11 d,平均9 d;术后胆漏1例,保守治愈。22例随访2～25个月,平均18个月,无结石复发及胆系症状。结论:腹腔镜胆总管切开取石T管引流术具有患者创伤轻、痛苦小、康复快等优点,值得临床应用。

Objective： To discuss experiences of laparoscopic choledocholithotomy with T-tube dminage. Methods： Clinical data of 22 patients who suffered from cholecystolithiasis and cboledocholithiasis and underwent laparoscopy were retrospectively analyzed. During the operation, the common bile duct was exposed before the removal of the gallbladder. The common bile duct was opened and the calculi were removed directly or with choledochoseope, and T-tube dminage was performed. Results：All operations were performed successfully without conversion to open surgery. The operative time was 100-180 min （mean, 120 min）, the blood loss was 5-30 ml （mean, 10 ml） and the postoperative hospital stay was 8-11 d （mean, 9 d）. Bile leakage occurred in 1 case and was cured with conservative treatment. During follow-up for 2-25 months （mean, 18 months） in 22 cases, no recurrence of calculi or biliary tract symptoms were observed. Conclusions：Laparoscopic common bile duct exploration and T-tube dminage has advantages of minor trauma,little pain and rapid recovery, thus is worth of wide application.