胆道镜在腹腔镜胆管结石手术治疗中的临床应用  

Clinical application of choledochotomy in laparoscopic bile duct calculus operation

作　　者：董加纯[1] 石天峰[1] 吕淑英[1] 陈德兴[1] 

机构地区：[1]吉林省前卫医院普通外科,吉林长春130012

出　　处：《吉林医学》2004年第6期48-49,共2页Jilin Medical Journal

摘　　要：目的探讨胆道镜在腹腔镜胆管结石手术中应用的价值。方法利用胆道镜灵活的转向、柔和的弯曲性,对腹腔镜下剖开胆总管的远端及肝内胆管进行探查、术中取石、狭窄胆管的治疗。结果本组72例胆管结石患者均术中应用胆道镜探查,单纯胆总管结石51例,术中取净50例;单纯肝内胆管结石7例,术中取净5例;肝内外共存结石14例,术中取净10例;肝内胆管狭窄8例,Oddi括约肌狭窄2例。对8例肝内胆管狭窄及2例Oddi括约肌狭窄进行球囊导管扩张治疗。结论胆道镜在腹腔镜胆管结石手术中的应用,提高了术中结石取出率及取净率;同时可以对胆管及Oddi括约肌狭窄进行诊断和术中治疗,提高了腹腔镜胆管结石一期治愈率,达到微创的目的。Objective To investigate the application value of choledochotomy in the operation under laparoscopic to extract bile duct calculus operation. Method Make use of the choledochotomy freely, winding softly treat common bile duct and liver bile duct exploration, extraction of bile duct calculus and stenosis.Results 72 patients who had bile duct calculi were all explorated,50 of 51 with common bile duct calculi patients are clear in the operation,5 of 7 patients with hepatolithiasis are clear,10 of 14 patients with hepatolithiasis and common bile calculus together are clear. 8 patients who had stenosis of liver bile duct and 2 patients stenosis of Oddi sphincter were treaed by the balloon dilatation catheter. Conclusion The application of choledochotomy to extract bile duct calculi under laparoscopie can improve the extraction and clear rate in the operation,at the same time can diagnose and treat stenosis of Oddi sphincter in the operation, improve Ⅰ cure rate of bile duct calculus to get the purpose of minimal invasiveness.

关 键 词：胆道镜 腹腔镜 胆管结石 治疗 

分 类 号：R657.4[医药卫生—外科学]