腹腔镜经胆囊管汇入部微切开胆总管探查取石22例分析

Analysis of 22 cases of laparoscopic exploration of common bile duct by micro-incision through cystic duct

目的探讨腹腔镜经胆囊管汇入部微切开胆总管探查取石治疗胆囊结石合并胆总管结石的价值。方法2017年10月至2019年12月,对22例胆囊结石胆囊炎合并胆总管结石患者采用腹腔镜经胆囊管汇入部微切开胆总管探查取石一期缝合术。沿胆囊管切口纵行切开胆总管侧壁3mm,完成胆道探查。结果22例均完成腹腔镜经胆囊管汇入部微切开胆总管探查取石一期缝合,22例全部取尽胆总管结石。手术时间为65~158(90.56±3.74)min;术后住院时间3~8(4.26±1.25)d;2例发生胆漏,保留腹腔引流6~7d后痊愈。21例(95%)随访4~29月,未发生胆总管狭窄及结石复发。结论腹腔镜下经胆囊管汇入部微切开联合胆道镜取石治疗胆总管结石临床效果较好。

Objective To evaluate the value of laparoscopic cholecystolithiasis combined with choledocholithiasis by micro-incision common bile duct exploration and lithotomy.Methods October 2017~December 2019,In 22 cases of cholecystitis with choledocholithiasis,laparoscopic cholecystectomy and lithotomy were performed in the first stage.Biliary exploration was performed by longitudinal incision of the lateral wall of the common bile duct 3 mm.Results The first stage suture of laparoscopic choledochotomy was completed in 22 cases.All 22 cases were treated with common bile duct stones.Operation time was 65~158(90.56±3.74)min;Postoperative hospital stay 3~8(4.26±1.25);Bile leakage occurred in 2 cases,retained abdominal drainage 6~7 d after recovery.21 cases(95%)were followed up for 4~29 months,No common bile duct stenosis and recurrence of stones occurred.Conclusion Laparoscopic micro-incision of cystic duct confluence combined with choledochoscopic removal is effective for choledocholithiasis.