腹腔镜胆总管探查术治疗胆总管结石55例报告

Laparoscopic common bile duct exploration in treating choledocholithiasis:a report of 55 cases

目的:探讨腹腔镜胆总管探查术(laparoscopic common bile duct exploration,LCBDE)治疗胆总管结石的手术技巧与临床疗效。方法:回顾分析2007年8月至2012年11月为55例胆总管结石患者行LCBDE的临床资料。结果:54例顺利完成LCBDE,1例中转开腹。术中出血量平均(35±15)ml,手术时间平均(115±26)min;术后住院6～12 d。术后1例发生胆漏,经引流后治愈;术后3例发生残余结石,经T管窦道胆道镜取石或液电碎石取石治愈。术后随访2～46个月,无胆管狭窄、胆管炎、复发及胰腺炎等并发症发生。结论:LCBDE治疗胆总管结石安全、可行,手术微创,适应证广泛,利于术后残余结石的处理。

Objective：To investigate the surgical skills and clinical efficacy of laparoseopic common bile duct exploration （LCBDE） in treatment of choledocholithiasis. Methods ： The clinical data of 55 patients of eholedocholithiasis who underwent LCBDE from Aug. 2007 to Nov. 2012 were retrospectively analyzed. Results：Fifty-four cases of LCBDE were successfully performed and 1 case was converted to open surgery. The mean operative time was （ 115 ± 26） min. The mean blood loss was （35 ± 15 ） ml. The postoperative hospital stay was 6-12 d. Bile leakage occurred in one patient three days after operation and was cured by drainage. Residual stones were found in 3 eases and were cured by choledochoseopic cholelithotomy or electrohydraulic lithotripsy through T tube sinus. No bile duct stricture, cholangitis, recurrence or pancreatitis was observed during the follow-up of 2-46 months. Conclusions：LCBDE for eholedocholithiasis is safe and feasible with the advantages of minimal invasion,wide indication and facilitating in dealing with postoperative residual calculi.