腹腔镜微创治疗胆囊切除术后胆总管结石的疗效

Efficacy of laparoscopic minimally invasive treatment of common bile duct stones after cholecystectomy

目的探讨胆囊切除术后胆总管结石采用腹腔镜微创治疗的临床效果。方法对78例接受胆囊切除术(腹腔镜胆囊切除术和开腹胆囊切除术)术后形成胆总管结石患者实施腹腔镜微创治疗。观察治疗效果。结果本组78例患者,除4例因分离粘连组织器官时造成损伤中转开腹外,其余74例患者顺利完成腹腔镜微创手术,手术成功率94.9%。手术时间53~135 min,平均手术时间94 min。无胆漏、肠漏,腹腔无感染。术后随访6~18个月,无胆道狭窄、胆管炎、无胆管残余结石。结论对胆囊切除术后胆总管结石患者实施腹腔镜胃肠手术,创伤小、恢复快、安全有效,值得临床推广。

Objective To investigate the clinical effect of laparoscopic minimally invasive treatment of common bile duct stones after cholecystectomy. Methods A total of 78 patients with common bile duct stones after cholecystectomy（laparoscopic cholecystectomy and open cholecystectomy） all received laparoscopic minimally invasive treatment, and their treatment effect was observed. Results Among of 78 patients, in addition to 4 cases due to injury caused by separation of adhesions and tissues converting to open laparotomy, the remaining 74 patients successfully completed laparoscopic minimally invasive surgery, with success rate as 94.9%. The operation time was 53~135 min, with an average of operation time as 94 min. There were no bile leakage, intestinal leakage, no infection in the abdominal cavity. The patients were followed up for 6~18 months without biliary stricture, cholangitis or residual bile duct stones. Conclusion Laparoscopic cholecystectomy for patients with choledocholithiasis after cholecystectomy is safe and effective with small trauma and quick recovery. So it is worthy of clinical promotion.