腹腔镜联合胆道镜治疗胆囊及胆总管结石的临床体会  

Cholecystolithiasis and choledocholithiasis treated with laparoscope combined with fibrocholedochoscope

作　　者：许峰峰[1] 肖隆斌[1] 赵振献[2] 谭进富[2] 龙硕[1] 谭敏[2] 

机构地区：[1]广州中山大学附属第一医院黄埔院区普外科,510700 [2]中山大学附属第一医院微创外科

出　　处：《岭南现代临床外科》2008年第5期359-360,376,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨腹腔镜联合纤维胆道镜治疗胆总管结石的可行性及临床应用价值。方法比较2000年～2007年我院对110例术前通过B超或内镜超声确诊的胆总管结石患者行腹腔镜联合纤维胆道镜胆总管切开取石术与同期100例开腹手术者的疗效。结果2组手术均获成功,腹腔镜组胆总管Ⅰ期缝合46例,置T管引流64例。开腹组均置T管引流。2组比较手术时间、术中出血量、住院日差异有统计学意义(P<0.05);术后并发症发生率、腹腔或切口感染率、残石率差异无统计学意义(P>0.05)。结论腹腔镜联合纤维胆道镜是治疗胆囊及胆总管结石安全、有效的方法,具有创伤小、痛苦轻、恢复快等微创优势,取净结石的情况下行胆总管Ⅰ期缝合,微创效果尤为明显。Objective To study the feasibility and applied value of laparoscopic surgery for cholecystolithiasis and choledocholithiasis. Methods The 210 cases with cholecystolithiasis and choledocholithiasis were diagnosed preoperatively by B mode or endoscopic uhrasonography. Among them, 110 cases with choledocholithiasis underwent laparoscopic choledocholithotomy and 100 cases underwent open surgery. The curative effects were compared between two groups. Results All cases were operated successfully. The common bile duct of 46 cases in laparoscopic group were sutured without T tubc drainage and the others in two groups had a T tubc drainage. In the two groups, totol operative time, intraopeative bleeding and hospitalization time had statistic difference （P〈0.05）. But the postoperative complication （bile leak, bleeding）, abdominal or incisional infection rate and residual stones rate had no statistic difference （P〉0.05）. Conclusion The laparoscopic surgery is a safe and effective method for cholecystolithiasis and choledocholithiasis. It has advantages of less injury and rapidly recovery and it can shorten hospitalization time, especially in the one stage suture group.

关 键 词：腹腔镜 纤维胆道镜 胆总管切开取石 

分 类 号：R657.4[医药卫生—外科学]