腹腔镜胆囊切除术后遗留胆总管结石的治疗体会

Experience in the Treatment of Choledocholithiasis after Laparoscopic Cholecystectomy

目的主要探讨腹腔镜胆囊切除术后遗留胆总管结石治疗体会,降低类似并发症的发生率。方法回顾性分析2016年4月至2017年2月我院收治的32例LC术后遗留胆总管结石患者相关病情资料。结果 LC术后含有30例患者发生不同程度的腹痛、发热及胆汁性腹膜炎等,其中给予保守治疗后痊愈出院的患者有7例,后随访3个月均无复发现象;给予EST治疗的患者含有16例,同时加以制酸、抗感染等联合治疗。1周后复查无明显异常后办理出院,随访半年时间内未见复发迹象;此外含有4例患者行胆总管切开取石手术,术后恢复良好,复查无遗留结石。结论患者经LC术后如无明显诱因产生腹痛发热等情况,需谨慎了解是否遗留结石可能,其次在治疗上可根据患者病情采用适当的手术方式进行治疗。

Objective To discuss the experience in the treatment of choledocholithiasis after laparoscopic cholecystectomy, and to reduce the incidence of similar complications. Methods The data of 32 patients with choledocholithiasis after LC in our hospital from April 2016 to February 2017 were analyzed retrospectively. Results After operation, 30 patients underwent LC with varying degrees of abdominal pain, fever and bile peritonitis, among which 7 patients recovered after conservative treatment and no recurrence after 3 months follow-up. Patients treated with EST contained 16 Cases, at the same time to acid, anti-infective and other joint treatment. One week after the review no obvious abnormalities for discharge, follow-up within six months no signs of recurrence;in addition to 4 cases of choledocholithiascotomy surgery, postoperative recovery was good, review without leaving stones. Conclusion After LC, if there is no obvious cause, such as abdominal pain, fever and so on, we need to be careful about whether or not to leave stones. Next, we can take appropriate surgical methods according to the patient's condition.