多种内镜联合治疗胆囊结石合并胆总管结石  

Multiple kinds of endoscopic combination in the treatment of cholecystolithasis associated with choledocholithiasis

作　　者：刘展东 陈亚进[2] 徐国权[2] 商昌珍[2] 

机构地区：[1]广东省佛山市顺德区龙江医院普外科,528318 [2]中山大学附属第二医院肝胆外科,广州510120

出　　处：《岭南现代临床外科》2006年第1期16-18,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的总结应用十二指肠镜、腹腔镜、电子胆道镜联合治疗胆囊结石合并胆总管结石的经验。方法从1999年1月至2005年1月应用多种内镜联合治疗胆总管结石98例。82例行内镜下括约肌切开(EST)网篮取石、腹腔镜胆囊切除术(LC)。16例术前行内镜鼻胆管引流(ENBD)、腹腔镜胆囊切除术、胆总管切开胆道镜取石术。结果本组98例,腹腔镜成功完成手术95例,3例中转手术,98例全部治愈。术后出现并发症11例,其中切口感染6例,轻型胰腺炎4例,少量胆汁漏1例。无返流性胆管炎,胆石复发等症状。结论多种内镜联合治疗胆囊结石合并胆总管结石,安全可靠,疗效确切,一般情况下可替代开腹胆囊切除、胆总管切开取石、T管引流术。Objective To summarize the experience in the application of duodenoseope, laparoseope and electronic eholedoehoseope for treating the eholeeystolithasis associated with eholedoeholithiasis. Methods From January 1999 to January 2005, three kinds of endoscope were used to treat eholedoeholithiasis in 98 eases.82 cases underwent endoscopic sphineterotomy and eholedoeholithotomy, laparoseopie eholeeysteetomy. 16 cases underwent endoscopic naso-bilian drainage before operation,laparoseopie eholecystectomy, eholedoehotomy and eholedoeoseopie eholelithotomy. Results 95 cases were cured by laparaseope. Postoperative complications were found in 11 cases. Among them, wound infection was in 6 cases, mild panereatitis 4 eass and small amount of biliary leakage 1 case. 3 cases were transterred to open abdominal operation because of bifurcation stricture of left and right hepatic duct and owing to adhesion and edema of porta hepatis respectively. No regurgitant eholangitis and recurrence of gall stones were occurred. Conclusion Multiple kinds of endoscopic combination are a safe,reliable and excellent efficacy in the treatment of eholeeystolithiasis associated with eholedolithiasis. In general condition,it can replace open eholeeysteetomy, eholedoeholithotomy and T tube drainage.

关 键 词：十二指肠镜 腹腔镜 胆道镜 胆囊结石 胆总管结石 

分 类 号：R657.3[医药卫生—外科学]