细导管在腹腔镜内镜同期治疗胆囊结石合并胆总管结石中的应用

Using fine catheter in laparoscopic and endoscopic treatment of gallbladder stones complicated with common bile duct stones

目的:探讨细导管(输尿管导管)在腹腔镜内镜同期治疗胆囊结石合并胆总管结石中的应用价值。方法:回顾分析经胆囊管放置细导管应用于腹腔镜内镜同期治疗胆囊结石合并胆总管结石57例患者的临床资料。结果:57例患者一次性内镜取石成功,结石取净率100%。无胰腺炎、胆道大出血、穿孔等并发症发生。发生高淀粉酶血症6例,经积极保守治疗后康复。术后平均住院(5.6±2.3)d。患者均获随访,B超检查未发现胆管残余结石,肝功能指标均正常。结论:腹腔镜内镜同期治疗胆囊结石合并胆总管结石,经胆囊管放置细导管对于内镜操作具有很好的帮助作用,简化了内镜治疗过程,明显减少了内镜并发症的发生。

Objective： To evaluate the value of the fine catheter in laparoscopic and endoscopic treatment of gallbladder stones complicated with common bile duct stones. Methods： The clinical data of 57 patients who suffered from cholecystolithiasis and choledocholithiasis and underwent laparoscopic and endoscopic treatment with the fine catheter through cystic duct were retrospectively analyzed. Results： Fifty-seven cases were successfully completed surgery,the stone clearance rate was 100%. There were no severe complications such as pancreatitis,bile duct hemorrhage or intestinal perforation. 6 patients suffered from hyperamylasemia and were cured after actively conservative treatment. Postoperative hospitalization time was（ 5. 6 ± 2. 3） d. All patients were followed up,B-ultrasound examination showed no residual bile duct stones and liver function indexes were all normal. Conclusions： Using fine catheter in laparoscopic and endoscopic treatment of gallbladder stones complicated with common bile duct stones plays a very helpful role in endoscopic operation,simplifies the process of endoscopic treatment and significantly decreases endoscopic complications.