腹腔镜技术在处理肝内胆管结石中的应用  

Application of Laparoscopic Technique in the Treatment of Hepatolithiasis

作　　者：罗华[1] 胡朝辉[1] 匡铭[1] 王宁[1] 张伟[1] 杨培[1] 黎前德[1] 

机构地区：[1]四川省绵阳市中心医院肝胆外科,四川绵阳621000

出　　处：《华西医学》2007年第3期556-557,共2页West China Medical Journal

摘　　要：目的:探讨腹腔镜技术治疗肝内胆管结石的适应症和手术技巧。方法:应用C臂X线机术中造影,纤维胆道镜术中术后取石,超声刀切肝,腹腔镜下缝合打结技术治疗肝内胆管结石105例;其中腹腔镜肝叶切除11例。结果:105例全部治愈,术后出现皮下气肿、腹腔积液、切口感染、肺部感染一般并发症14例,无出血、胆漏及腹腔脏器损伤等严重并发症。术后平均12h下床活动,26h进食,术后平均住院5天。结论:掌握严格的手术适应症,具备一定的设备和腹腔镜下切肝和熟练的腹腔镜下缝合打结技术,可以利用腹腔镜技术完成对肝内胆管结石病人的治疗。Objective： To investigate the indications and operation skill of laparescopie treatment for patients with hepatolith. Methods： A retrospective clinical analysis was made in 105 patients with hepatolith. The operations were done by means of laparoscope and the techniques that included intraoperative eholangiography, eholedochofiberscope, ultrasonically activated scalpel and suture and ligation skill were used in these procedures. Among the 105 patients, 11cases tmderwent laparescopie hepatectomy. Results： Procedures were all successful and all patients were cured, subcutaneous aeroeele, abdominal fluid collection, incision and lung infection occurred in 14 eases. No serious complications （bleeding, bile leakage and injury of abdominal viscera） were observed. The average time of lying in bed was 12h, the average fast time was 26h and the average hospitalized time was 5 days. Conclusion： Laparoscopie treatment is feasible in selected patients with hepalith, it is safe and effective in the hands of skilled endescopists. Of course, in order to ensure performing operations suecessfially, some apparatus and laparoseopie skill are essential.

关 键 词：手术学 腹腔镜外科 肝内胆管结石 

分 类 号：R657.42[医药卫生—外科学]