腹腔镜及胆道镜联合治疗胆道结石42例

Laparoscopy and cholecochoscopy in the treatment of cholangiolithasis

目的 探讨腹腔镜及胆道镜联合治疗胆道结石的疗效。方法 腹腔镜及胆道镜配合,42例胆道结石患者均常规先行腹腔镜胆囊切除术;20例行腹腔镜胆总管切开胆道镜取石放T管引流术(LCTD);22例行腹腔镜胆总管切开胆道镜取石不放T管一期缝合术。结果 42例均顺利完成了手术,平均手术时间68分钟,取出0.2～2.4cm结石1～40枚。除2例术后出现胆瘘外,未见其他并发症。结论 腹腔镜、胆道镜联合治疗胆道结石,患者住院时间短,并发症少,恢复快,是一项可靠、安全的微创技术,此方法大大优于传统开腹术式。

Objective To study the clinical value of using laparoscopy combined with cholecochoscopy in the treatment of cholangiolithasis. Methods All the patients initially underwent laparoscopic cholecystectomy. then in the 20 cases of choledocholithiasis LCTD was performed, and the other 22 patients submitted to laparoscopic choledochotomies with primary closure of the common bile duct. Results The Laparoscopic common bile duct exploration (LCBDE) was performed successfully in all the cases. The mean operative time was 68 minutes. The diameter of the stones was 0. 2～2. 4 cm, and the number was 1～40. Two patients had complications of bile leaks. Conclusions The LCBDE was associated with shorter hospital stay and less rate of complications than choledochotomy. We conclude that this method is rapid, reliable and safe, and primary closure of the common bile duct is the preferred technique after laparoscopic choledochotomies.