腹腔镜胆囊切除联合内镜乳头括约肌切开Ⅰ期治疗胆道结石15例  

Treatment of cholecystochole docholithiasis by single-stage laparoscopic cholecystectomy combined with endoscopic sphincterotomy:an analysis of 15 cases

作　　者：何忠野[1] 郭仁宣[1] 

机构地区：[1]中国医科大学附属第一医院普外科,辽宁省沈阳市110001

出　　处：《世界华人消化杂志》2007年第9期1034-1036,共3页World Chinese Journal of Digestology

摘　　要：目的:探讨联合应用腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)和内镜乳头括约肌切开(endoscopic sphincterotomy,EST)胆总管取石Ⅰ期治疗胆囊及胆总管结石的临床应用价值.方法:对15例胆囊及胆总管结石患者(术前经B超及MRCP确诊)行EST,胆总管取石成功后行三孔法LC手术.术后禁食、禁水、补液支持治疗,抑制胰酶活性并预防性抗炎治疗,同时监测血淀粉酶.结果:15例EST均获成功.1例有少量出血后止,3例出现一过性血淀粉酶升高,但无胰腺炎发生.患者术后均恢复顺利,术中和术后无严重并发症发生,术后5-7 d出院.随访治疗效果满意.结论:LC联合应用EST取石Ⅰ期治疗胆囊及胆总管结石切实可行,该方法具有微创、安全的特点,充分发挥了微创外科手术的优势.AIM： To evaluate the clinical values of laparoscopic cholecystectomy （LC） combined with endoscopic sphincterotomy （EST） in treatment of patients with cholecystocholedocholithiasis. METHODS： Fifteen cases, diagnosed with cholecystocholedocholithiasis by B-ultrasound and magnetic resonance cholangiopancreatography （MRCP）, were selected in this study. EST was firstly were performed, and then LC operation was achieved. After the operation, the following measures were administrated, such as fasting, water deprivation, liquid supplement, reducing the activity of pancreatin and anti-inflammatory therapy. Meanwhile, the level of blood amylase was monitored. RESULTS： EST was successfully accomplished in all the 15 cases. A little haemorrhage occurred in 1 case after the operation. Three cases exhibited high amylase level temporarily, but no pancreatitis appeared. All the patients recovered well after the operation, and no severe complications were observed. The in-hospital time was 5 to 7 days, and a favorable result of following up was obtained. CONCLUSION： The single-stage LC combined with EST is feasible and safe in the treatment of patients with cholecystocholedocholithiasis.

关 键 词：胆总管结石 腹腔镜胆囊切除术 括约肌切开取石术 

分 类 号：R657.4[医药卫生—外科学]