腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石(附48例报告)

Treatment of cholecystolithiasis complicated with choledocholithiasis by laparoscopy together with choledochoscopy:with a report of 48 cases

目的:探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床应用。方法:回顾分析为48例胆囊结石合并胆总管结石患者行腹腔镜联合胆道镜治疗的临床资料。结果:1例中转开腹。28例一期缝合胆总管,20例放置T管引流。手术时间平均(75.0±12.5)min。术后2例出现胆漏,3～5 d后自愈;2例结石残留,经T管窦道胆道镜成功取出。术后平均住院(5.5±1.6)d。结论:腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石安全、可行,手术创伤小、术后康复快。

Objective：To investigate the clinical application of laparoscopy combined with choledochoscopy in the treatment of cholecystolithiasis complicated with choledocholithiasis. Methods：The clinical data of 48 patients who suffered from cholecystolithiasis and choledocholithiasis and underwent laparoscopy together with choledochoscopy were retrospectively analyzed. Results：One case was converted to open surgery. Common bile duct incision of 28 cases was sutured at the first stage without T tube. 20 cases were placed with T tube. The average operation time was （75.0 ＋ 12.5） min. 2 patients suffered from bile leakage,which was cured spontaneously in 3 to 5 days. Retained stone was detected in 2 patients and was successfully removed through choledochoscopy. The average length of hos- pital stay after operation was （5.5 ＋ 1.6） d. Conclusions： The treatment of cholecystolithiasis complicated with choledocholithiasis by laparoscopy together with choledochoscopy is a safe ,feasible and minimally invasive method with little surgical trauma and fast postoper- ative recovery.