腹腔镜联合纤维胆道镜保胆取石治疗青少年胆囊结石临床体会

Clinical Experience for Removal of Calculus and Preservation of Gallbladder with Laparoscope and Choledochoscope in Treating Youngsters with Cholecyslithiasis

目的:评价腹腔镜辅助下纤维胆道镜小切口保胆取石治疗青少年胆囊结石的临床疗效。方法:我院2008年7月至2011年7月间共有28例青少年胆囊结石患者采用腹腔镜辅助下纤维胆道镜小切口保胆取石治疗;搜集本组病例的临床资料和随访资料进行回顾性分析。结果:本组病例均手术顺利,术中无中转行胆囊切除术,术后恢复顺利,1例出现伤口感染,无出血、胆瘘等并发症;随访1-2年,1例失防,1例出现复发性胆囊结石,1例出现左肝内胆管结石,但未见胆囊结石,故本组复发率为(1/27)3.7%。结论:严格把握手术适应证,采用腹腔镜辅助下纤维胆道镜小切口保胆取石治疗胆囊结石安全、效果好,术后无明显并发症且复发率低。

Objective： Observing and evaluating the clinical effect of calculus and preservation of gall- bladder with laparoscope and eholedochoscope with tiny cut to treat youngsters with choleeyslithiasis. Meth- od： There were 28 cases of youngsters with cholecyslithiasis treated by removal of calculus and preservation of gallbladder with laparoseope and choledochoseope in our hospital from July 2008 to July 2011 . Collected and analyzed retrospectively the clinical data and follow-up data of all the cases. Result： All the cases were smooth operation without turning to choleeystectomy and postoperative recover smoothly. There was no posto- peration complications such as bleeding and biliaryfistula except one case appeared wound infection. All ca- ses except one were follow-up for one to two years. Then, one ease appeared recurrent gallstones, and an- other appeared stones in the left intrahepatic bile duct, but no gallstones. Therefore, the ratio of the group was 3.7%. Conclusion： On condition that grasping operation indications strictly, calculus and preservation of gallbladder with laparoscope and choledochoscope with tiny cut to treat choleeyslithiasis is not only safe and effective but no obvious complications and lower ratio.