纤维胆道镜下胆囊切开取石保胆治疗胆囊结石612例随访结果分析  

The analysis of follow-up results of 612 cases of cholecystolithiasis treated with the minimal invasive operation with gallbladder preserved via choledochoscopy

作　　者：刘京山[1] 李晋忠[1] 赵期康[1] 金斗[1] 侯郑生[1] 黄坤全[1] 杜文[1] 于景波 张宝善[3] 康晓平[4] 

机构地区：[1]北京大学首钢医院普外科,100041 [2]大庆市中医院普外科 [3]北京大学第一医院外科 [4]北京大学公卫学院流行病与卫生统计学系

出　　处：《中华外科杂志》2009年第4期279-281,共3页Chinese Journal of Surgery

摘　　要：目的探讨纤维胆道镜下胆囊切开取石保胆手术治疗胆囊结石的可行性。方法回顾性分析1992年2月至2006年6月接受纤维胆道镜下胆囊切开取石保胆手术治疗胆囊结石的760例患者的临床资料，其中男性428例，女性332例；年龄18～81岁，中位年龄43岁。所有患者术前均经超声明确诊断，术前经口服胆囊造影或核医学显像，提示胆囊功能正常。所有患者术中均将胆囊结石全部取净。结果共行纤维胆道镜下胆囊切开取石保胆手术760例，随访到612例，随访率80．5％，术后全部恢复良好，术后每年进行一次随访，随访1～15年，术后1年胆囊结石的复发率为0．49％，2年复发率为4．39％，3年复发率为5．83％，5年复发率为6．60％，7年复发率为7．21％，9年复发率为8．38％，10年和15年复发率均为10．11％。结论纤维胆道镜下胆囊切开取石保胆手术对有功能的胆囊结石患者有良好的治疗效果，保留了有功能的胆囊，提高了患者的生存质量，是一种可行的手术方式。Objective To discuss the feasibility of the operation of minimal invasive with gallbladder preserved via choledochoscopy. Methods From February 1992 to June 2006, there were 760 patients who underwent cholecystolithiasis treated with the minimal invasive operation with gallbladder preserved via choledochoscopy, among which there were 428 males and 332 females, aged from 18 to 81 years old. All cases were diagnosed by ultrasonography and their gallbladder functions were proved normal by the examination of oral cholecystography or ECT before operation. In the operation gallstones were removed from gallbladder completely. Results There were 612 cases who were followed up for 1-15 years and the follow-up rate was 80. 5 %. All patients recovered well after operation. The post-operation rate of recurrence of gallstone was 0. 49% ,4. 39% ,5.83% ,6. 60% ,7.21% and 8.38% within the first year,the second year, the third year, the fifth year, the seventh year and the ninth year respectively, rate of recurrence of gallstone were 10. 11% within both the tenth and the fifteenth year. Conclusions The minimal invasive operation with gallbladder preserved via choledochoscopy is effective to choleeystolithiasis patients whose gallbladder function is normal. It is a feasible operation that preserves the normal functional gallbladder and improves the patients＇ life quality.

关 键 词：胆囊结石病 外科手术 纤维胆道镜 

分 类 号：R686[医药卫生—骨科学]