胆总管结石行腹腔镜胆总管探查术治疗体会

Treatment of Common Bile Duct Stones with Laparoscopic Common Bile Duct Exploration

目的探讨胆总管结石行腹腔镜胆总管探查术的临床价值。方法回顾性分析2014年3月-2018年3月就诊漳州正兴医院肝胆胰外科行腹腔镜胆总管探查术的135例胆总管结石患者,收集并统计分析相关临床资料。结果所有患者中103例合并胆囊结石,10例患者合并有肝段或肝叶萎缩,其中左外叶8例(8%),肝右后叶1例(1%),左内叶1例(1%),术中横结肠破裂1例,术后出现麻痹性肠梗阻3例,胆漏2例,出血2例,感染1例,均无围手术期死亡。结论胆总管结石行腹腔镜胆总管探查术是安全可行,联合胆总管一期缝合在有腔镜经验的基础医院值得逐步开展。

Objective To explore the clinical value of laparoscopic common bile duct exploration for common bile duct stones.Methods A retrospective analysis of 135 patients with common bile duct stones who underwent laparoscopic common bile duct exploration in the Department of Hepatobiliary and Pancreatic Surgery of Zhangzhou Zhengxing Hospital from March 2014 to March 2018 was collected and statistically analyzed.Results Among all the patients,103 cases had gallbladder stones,and 10 cases had hepatic segment or hepatic lobe atrophy,8 of which were left outer lobe(8%),1 of right hepatic lobe(1%),and 1 of left inner lobe(1%),1 case had transverse rupture of the colon,3 cases had paralytic intestinal obstruction,2 cases had bile leakage,2 cases had bleeding,and 1 case had infection.No perioperative death occurred.Conclusion Laparoscopic common bile duct exploration for common bile duct stones is safe and feasible.The combined primary bile duct suture in a basic hospital with laparoscopic experience is worth gradually developing.