可视胆管镜取石钳在腹腔镜保胆取石术中的临床疗效

Clinical Effect of Visual Choledochoscope Forceps in Laparoscopic Cholecystolithotomy Preserving the Gallbladder for Cholecystolithiasis

目的探讨自行设计的可视胆管镜取石钳在腹腔镜保胆取石术中的取石效果及应用价值。方法选取2015年12月至2017年12月于秦皇岛市第一医院就诊的胆囊结石患者56例,应用胆管镜取石钳行腹腔镜保胆取石术,观察患者手术情况、手术并发症及胆囊结石复发情况。结果术后复查超声证实56例均未残留结石,有效率为100%,无围手术期死亡病例。手术时间40~60 min,平均(52.5±4.3)min;术中出血量10~15 mL,平均(12.3±1.2)mL;术后平均住院时间(5.0±1.4)d;发生胆漏1例(1.7%),戳孔感染2例(3.5%),其他术后并发症如脂肪液化及术后出血未发生,并发症发生率为5.3%。结论对于胆囊结石者采取胆管镜取石钳行腹腔镜保胆取石术治疗效果确切,能减少术中出血量、缩短手术时间、减少手术对机体的侵袭,是一种值得推荐的治疗方式。

Objective To investigate the effect and applicative value of visual choledochoscope forceps designed by ourselves in laparoscopic cholecystolithotomy preserving the gallbladder.Methods A total of 56 cases of gallbladder stone in Qinhuangdao First Hospital from Dec.2015 to Dec.2017 were included in the study.The patients were treated with visual choledochoscope lithotomy forceps in laparoscopic cholecystolithotomy preserving the gallbladder,and the surgery situation,complications and gall stones recurrence were analyzed retrospectively.Resutls B-type ultrasound confirmed that the stones were completely removed in all of the 56 cases.There were no perioperative deaths.The operative time was 40-60 min,with an average of(52.5±4.3)min.The intraoperative bleeding was 10-15 mL,with an average of(12.3±1.2)mL.The average time of postoperative hospital stay was(5.3±1.4)d.The postoperative complication incidence was 5.3%,including biliary fistula 1 case(1.7%)and puncture hole infection 2 cases(3.5%).The other complications such as fat liquefaction and postoperative bleeding did not occur.Conclusion Choledochoscope forceps in laparoscopic cholecystolithotomy preserving the gallbladder for cholecystolithiasis has affirmative effect,which can reduce blood loss,shorten operative time and reduce surgical trauma,thus is a treatment worth of recommendation.