老年胆石症患者腹腔镜胆总管切开取石一期缝合35例分析  

Laparoscopic common bile duct exploration and primary suture for the treatment of thirty-five elderly patients with common duct stones

作　　者：刘东斌[1,2] 刘家峰[1,2] 徐大华[1,2] 王悦华[1,2] 仝小刚[1,2] 郑亚民[1,2] 蔡伟[1,2] 张小丽[1,2] 王会元[1,2] 王剑[1,2] 李非[1,2] 

机构地区：[1]首都医科大学普通外科学系 [2]首都医科大学宣武医院普通外科,北京市100053

出　　处：《实用老年医学》2013年第10期847-849,共3页Practical Geriatrics

摘　　要：目的探讨腹腔镜胆总管切开取石一期缝合治疗老年胆总管结石可行性及安全性。方法选取2009年12月至2012年8月行腹腔镜、纤维胆道镜联合治疗胆囊结石、胆总管结石,一期胆总管缝合≥65岁老年病人35例。完全腹腔镜下胆囊切除,联合胆总管切开通过胆道镜置入取石网篮取石,术毕一期缝合胆总管。结果本组腹腔镜胆道镜联合行胆总管探查取石术成功率为100%,手术时间57~170 min,出血量10~100 ml,术后住院时间5~10 d,发生胆漏2例,再次手术1例。术后随访4月至2年,残余胆总管结石1例。结论在严格把握手术指征,认真评价术前影像学,术中熟练胆道镜操作,精准缝合的前提下,老年病人腹腔镜胆总管切开取石一期缝合治疗胆总管结石是安全可行的。Objective To explore the feasibility and security for laparoscopic common bile duct exploration and primary suture(LBEPS) to treat the elderly patients with common bile duct stones.Methods Thirty-five elderly patients with common duct stones and gallbladder stones treated by laparoscopic common bile duct exploration and primary suture were analyzed retrospectively from December 2009 to August 2012.Results All 35 elderly patients were treated by LBEPS successfully.The operative time was 57-170 minutes,the amount of bleeding was 10-100 ml,and the postoperative hospital stay was 5-10 days.Bile leakage appeared in 2 cases,and 1 case received another operation.All patients were followed up for 4 months to 2 years.One case presented with residual common bile duct stones.Conclusions Choledochoscope technology is safe and feasible for LBEPS to treat the elderly patients with common bile duct stones.

关 键 词：腹腔镜胆总管切开取石一期缝合 胆道镜 胆总管结石 老年人 

分 类 号：R657.4[医药卫生—外科学]