胆管镜经胆囊管胆管探查取石36例临床分析

Choledochoscopy via the Cystic Duct Stone Exploration 36 Cases

目的探讨胆管镜经胆囊管胆管探查取石的可行性及适应证。方法对具有胆管探查取石指征的患者,施行胆管镜经胆囊管扩张或辅以胆囊管汇入部微切开后进行胆管检查和取石,完成后不放置T管,直接结扎或缝合胆囊管。结果 36例中7例探查阴性,29例发现胆总管结石,经胆囊管扩张或辅以胆囊管汇入部微切开后进行胆管镜取石,均顺利清除结石,结石清除率为100%。无住院期间死亡及胆漏等并发症发生。术后住院时间4～9d,平均住院6.5d。结论该术式有适当的手术指征、创伤小、并发症少、住院时间短的特点,符合微创外科的原则,降低胆总管阴性探查率,是部分胆石症患者较为理想的方法。

Objective To evaluate the bile duct choledochoscopy via the cystic duct stone exploration of the feasibility and indications. Methods The bile duct exploration with stone extraction in patients with indications, implementation of chole- dochoscopy via the cystic duct cystic duct dilatation or supported by the Ministry of Micro cut import inspection and after biliary tract stone, not after T - tube placement, or suture ligation of the cystic duct directly. Results 36 cases of negative exploration in 7 cases, 29 cases found in the Choledocholithiasis through the cystic duct cystic duct dilatation or supplemented by the Depart- ment of Micro - import after cholangioscopy cut stones v^ere successfully removed stones, stone clearance rate was 100%. No hospital mortality and complications such as bile leakage occurred. Postoperative hospital stay was 4 - 9d, the average hospital stay 6. 5d. Conclusion The appropriate surgical indications for surgery, trauma, fewer complications, shorter hospital stay characteristics, in line with the principles of minimally invasive surgery to reduce the negative common bile duct exploration rate, is part of the ideal method in patients with cholelithiasis.