双镜联合保胆取石术126例报告

The report of cholecystolithotomy with double endoscopes on 126 patients

目的:探讨腹腔镜与胆道镜联合行保胆取石术的手术指征、方法及技巧。方法:回顾分析2010年5月至2012年5月为126例患者行腹腔镜联合胆道镜保胆取石术的临床资料。结果:122例顺利完成保胆取石术;2例因胆囊内泥沙样结石取石不满意改行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC),2例因术中切开胆囊后见白色胆汁流出,胆囊管基本闭锁,改行LC。术后均无并发症发生,出院后服用熊去氧胆酸6个月,随访3～15个月,未见结石复发。结论:把握手术适应证,双镜联合行保胆取石术安全、可行,保留了功能较好的胆囊,满足了患者对保胆的需求。

Objective：To discuss the operative indications,methods and techniques of cholecystolithotomy with laparoscope and choledochoscope.Methods：The clinical data of 126 cases of laparoscopic and choledochoscopic cholecystolithotomy from May 2010 to May 2012 were retrospectively analyzed.Results：One hundred and twenty-two cases were performed successfully.2 cases were converted to laparoscopic cholecystectomy（LC） because of sandy stones while the other 2 were converted to LC due to the atresia of cystic duct.No postoperative complications were recorded.All the patients took ursodeoxycholic acid for six months postoperatively.During the follow-up of 3-15 months,no recurrence occurred.Conclusions：Cholecystolithotomy with double endoscopes is safe and feasible on selective patients.It can preserve the functional gallbladder and meet the demands of some patients.