经腹腔镜联合胆道镜治疗肝外胆管结石138例临床分析

Clinical analysis of 138 cases undergoing laparoscopy combined with choledochoscopy in treatment of bile duct stones

目的总结经腹腔镜联合胆道镜治疗肝外胆结石的手术方法和临床经验。方法回顾分析我院2009年1月至2011年5月经腹腔镜胆总管切开探查、纤维胆道镜取石及T管引流术患者的临床资料。结果 138例中通过该手术方法成功完成135例,3例中转开腹,手术时间平均96min,术后21～60d(平均40d)拔出T管,无胆漏、胆道狭窄、胆道出血和残余结石等手术并发症。结论经腹腔镜联合胆道镜治疗肝外胆管结石创伤小、患者痛苦小、康复快、腹腔脏器干扰少、美容效果好等优点,治疗效果优于开腹手术。

Objective To summarize the laparoscopy combined with choledochoscopy in treatment of extrahepatic cholelithiasis operation methods and the clinical experience. Methods Retrospective analysis of our hospital in 2009 January to 2011 May menstrual laparoscopic common bile duct exploration, choledochofiberscope and T tube drainage in patients with clinical data. Results Among the 138 cases, the operation method was performed successfully in 135 cases, 3 cases were converted to laparotomy, the average 96min operation time, postoperative 2 ld ～ 60d（average 40d） pulling out T tube,no bile leaks,biliary stenosis,biliary tract bleeding and residual stone operation complication. Conclusion By laparoscopy combined with choledoch- oscopy in treatment of calculus of extrahepatic bile duct trauma, with less pain, faster recovery, less interference, abdominal viscera excellent cosmetic effect, therapeutic effect was better than that of open operation.