腹腔镜联合硬质胆道镜治疗胆总管结石38例分析

The Analysis of Laparoscopy Combined with Rigid Choledochoscope in the Treatment of 38 Cases of Common Bile Duct Stones

目的：探讨腹腔镜联合硬质胆道镜治疗胆总管结石的临床价值。方法：对本院2010年6月-2013年6月应用腹腔镜联合硬质胆道镜治疗38例胆总管结石病例资料进行回顾分析。手术方式采用腹腔镜下胆囊切除、胆总管切开、硬质胆道镜取石、T管引流术。结果：37例手术成功，1例中转开腹（因胆囊坏疽，胆总管明显水肿）。术后2例出现胆漏，量小于100 ml，引流3～5 d自愈；1例出现术后小残石，经再次胆道镜取出，术后5～7 d带T管出院，3周后行T管造影，夹管1～2 d，无结石，拔除T管。结论：腹腔镜联合硬质胆道镜是治疗胆总管结石的安全有效的微创方法。

Objective：To investigate the clinical value of treatment to common bile duct calculi by laparoscopic combined rigid choledochoscope. Method：Retrospective analysis of 38 cases of common bile duct calculi cases data applied with laparoscopy combined rigid choledochoscope from the June 2010 to June 2013. The laparoscopic gallbladder excision,common bile duct incision,rigid choledochoscope lithotomy and the T tube drainage were operation methods. Result：37 cases were successful,and 1 case was conversed to open surgery（for gallbladder necrosised and the common bile duct obvious edema）. There were 2 cases appeared bile leakage after operation,but the amount was less than 100 ml,heal itself by drainaged of 3-5 days. 1 case appeared small residual stone postoperative,the choledochoscope out again. All cases were out of the hospital in 5 to 7 days with T tube,then T tube radiography after three weeks,and clipped the pipe 1-2 days,pulled out the T tube when no stones. Conclusion：The minimally invasive method of treatment to common bile duct stones by laparoscopic combined rigid choledochoscope is safe and effective.