腹腔镜胆总管切开纤维胆道镜取石胆总管一期缝合60例分析

Choledochotomy under laparoscopy and choledocholithotomy by fibro-optic choledochoscopy with primary closure of the commn duct wound(analysis of sixty cases)

目的 :探讨腹腔镜下胆总管切开、纤维胆道镜取石后胆总管一期缝合术式的治疗效果。方法 :6 0例胆总管结石病人 (其中原发性胆总管结石 5例 ) ,在腹腔镜下行胆总管切开、纤维胆道镜取石后一期缝合。结果 :手术时间为 (110± 4 0 )min ,失血量为 (5 0± 2 0 )ml,进食时间为 (4 8± 4 )h ,下床活动时间为 (5 5± 7)h ,术后出院时间为 (4 .5± 0 .5 )d ,无一例发生与手术相关的并发症。结论 :腹腔镜下胆总管切开纤维胆道镜取石后行胆总管一期缝合疗效好、安全。只要镜下取净结石 ,肝外胆管无狭窄 ,均可一期缝合。该术式具有创伤小、痛苦轻、恢复快、并发症少等优点 。

Objective:To ascertain the efficacy and to investigate the outcome of choledochotomy under laparoscopy and choledocholithotomy by fibro optic choledochoscopy with primary closure of the commn bile duct wound after the completion of gallstone extraction.Methods:Sixty cholecystolithiasis patients complicated with choledocholith with 5 cases of primary choledocholithiasis included were studied.Results:The operative procedures were all successful with an average operation time (110±40)min,average estimated blood loss (50±20)ml,mean time of ingestion after operation and ambulation were (48±4)h and (55±5)h,respectively with no operative related complications encountered.Conclusion:It is conluded that the whole procedures of above mentioned operation were save with lesser operative trauma and more rapid recovery with minimal uneasiness of the patients. The incision of common bile duct can be all sutured primarily provided with complete extraction of common bile duct stones and without extrahepatic bile duct stricture. So that,these advanced operative procedures can be extended and popularized.