腹腔镜联合胆道镜胆总管探查取石一期缝合术46例报告

Laparoscopic common bile duct exploration with choledochoscope and primary suture of common bile duct:with a report of 46 cases

目的:探讨腹腔镜联合胆道镜胆总管探查取石一期缝合术的手术方法、适应证,并评估其安全性及手术价值。方法:回顾分析2005年1月至2010年1月为46例患者施行腹腔镜联合胆道镜胆总管探查取石一期缝合术的临床资料。结果:46例手术均获成功,术后无结石残留;1例发生胆漏,经急诊ERCP置入胆道支架治愈;术后无胰腺炎发生。随访6～36个月,无残余结石及胆管狭窄。结论:腹腔镜联合胆道镜胆总管探查取石一期缝合术可作为治疗胆总管结石的常规术式,术中可彻底取净结石,防止结石残留。

Objective：To explore the methods,indications and evaluate the safety,benefit of laparoscopic common bile duct exploration with choledochoscope and primary suture of common bile duct.Methods：The clinical data of 46 cases undergoing this operation between Jan.2005 and Jan.2010 was collected and retrospectively analyzed.Results：All operations were successfully performed with no residual calculi.Bile leakage occurred in one patient and was cured by emergency ERCP;no pancreatitis occurred.The follow-up lasted for 6-36 months,and no bile duct stricture or residual calculi were found.Conclusions：Laparoscopic common bile duct exploration with choledochoscope and primary suture of common bile duct could be a routine method for common bile duct stones.