腹腔镜联合胆道镜治疗胆管结石的现状及进展

Current situation and progress of laparoscopy combined with choledochoscopy in the treatment of bile duct stones

胆管结石是我国常见的胆道疾病,具有病情复杂、治疗难度大、容易复发等临床特点。随着腹腔镜、胆道镜、十二指肠镜、碎石器械等先进技术的广泛开展,腹腔镜联合胆道镜已成为胆管结石微创治疗的主流术式,比传统手术创伤小,并发症少,术后恢复快。该技术包括腹腔镜下胆总管切开取石术(LCCBDE)、腹腔镜下经胆囊管切开取石术(LTCBDE)、三镜联合技术、经腹腔镜肝部分断面置入胆道镜取石等,各有优缺点。针对不同类型的胆管结石合理选择相应的操作技术,才能使患者最大获益。本文对腹腔镜联合胆道镜治疗胆管结石的研究现状和进展进行探讨。

Bile duct stones are common biliary diseases in China,which have the clinical characteristics of complicated condition,difficult treatment and easy recurrence.With the extensive development of advanced technologies such as laparoscopy,choledochoscopy,duodenoscopy and lithotripsy instruments,laparoscopy combined with choledochoscopy has become the mainstream of minimally invasive treatment for bile duct stones,with less trauma,fewer complications and faster postoperative recovery than traditional surgery.This technique includes laparoscopic choledochotomy for common bile duct exploration(LCCBDE),laparoscopic transcystic common bile duct exploration(LTCBDE),three-mirror combined technique,and laparoscopic transhepatic cholangioscopy,each of which has its own advantages and disadvantages.Reasonable selection of appropriate surgical techniques for different types of bile duct stones is essential to maximize the benefits for patients.This paper discusses the research status and progress of laparoscopy combined with choledochoscopy in the treatment of bile duct stones.