腹腔镜联合胆道镜治疗胆总管结石84例

Clinical study on the treatment of common bile duct stones by laparoscopy combined with choledochoscopy in 84 cases

目的探讨腹腔镜联合胆道镜在治疗胆总管结石中的临床应用价值。方法 2008年5月—2011年5月,联合应用腹腔镜和纤维胆道镜行胆囊切除术、胆总管探查取石及T型管引流治疗胆总管结石病人84例,并回顾性分析手术时间、术后胆总管引流时间、术后住院天数、并发症等。结果 84例无中转开腹,平均手术时间120min;术后疼痛轻,无胆漏、胆道出血、急性胰腺炎、腹腔感染及胆道结石残留等并发症;术后住院时间5～7d(带T型管出院),T型管放置时间为4周。结论腹腔镜联合胆道镜治疗胆总管结石具有损伤小、痛苦轻及恢复快等优点,效果可靠,具有广泛的临床应用价值。

Objective To investigate the clinical value of laparoscopy combined with choledochoscopy in treatment of common bile duct stones. Methods From May 2008 to May 2011,84 patients were admitted and received cholecystotomy by laparoscopy combined with choledochoscopy,common bile duct exploration and removing stone,T-tube drainage treatment.Clinical data of operating time,postoperative drainage time,postoperative hospitalizational time and complications were retrospectively analyzed. Results All operations were successful without any subsequent laparectomy,the average operative time was 120 min.There were less postoperative pain in patients,no bile leakage,hematobilia,acute pancreatitis,abdominal infection,residual stones and other serious complications occurred.The hospitalization after surgery was 5-7d and the T tube was taken out of after 4 weeks. Conclusion Laparoscopy combined with choledochoscopy is effective,safe and reliable treatment for common bile duct stones,it has advantages as minimal invasion,light pain and quick recovery and the widespread application value.