腹腔镜与内镜联合治疗胆囊及胆总管结石的临床研究  

ERCP and EST before laparoscopic cholecystectomy for treatment of patients with cholelithiasts concurrent with choledocholithiasis

作　　者：郑元超[1] 夏焱[1] 黄明哲[1] 姜波健[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院普外科,上海201900

出　　处：《国际外科学杂志》2009年第9期591-594,共4页International Journal of Surgery

摘　　要：目的观察内镜逆行胰胆管造影（ERCP）和内镜十二指肠乳头括约肌切开术（EST）在腹腔镜胆囊切除术（LC）术前对胆囊、胆总管结石的治疗作用。方法回顾性分析2006年1月～2008年12月间上海交通大学医学院附属第三人民医院实施的43例（包括EST，ENBD和网篮取石术等）联合治疗的方法和经验。结果手术成功40例，成功率为93％。对胆总管结石内镜取石治疗成功率为95．2％，ERCP并发症2例（4．65％），高淀粉酶血症1例，乳头切开处出血1例，均经非手术治疗痊愈。结论ERCP和EST的应用是当前LC手术前治疗胆囊结石合并胆总管结石的最佳手段，对提高LC的成功率和减少LC的并发症，降低胆总管结石开腹手术的比率，均具有重要的作用。Objective To summarize the curative effect of ERCP and EST before laparoscopic cholecystectomy for treatment of patients with cholelithiasts concurrent with choledoeholithiasis. Methods A retrospective analysis was carried out for 43 cases of cholelithiasis concurrent with choledocholithiasis from January 2006 to December 2008. Results The procedures were successfully accomplished in 40 patients, the success rate was 93%. The successful clearance rate of common bile duct stone was 95.2%. Complication occurred in 2 cases, including 1 case of papilla bleeding and 1 case of hyperamylesemia. All complications were cured with non-operating treatment. Conclusions ERCP and EST before laparoscopic eholecystectomy is the best treatment and diagnosis method in gallbladder stone with common bile dust stone. It is very important to improve the success rate of LC, decrease complication and occurrence of the open operation of common bile duct stone.

关 键 词：胰胆管造影术 内镜逆行 括约肌切开术 内窥镜 胆囊切除术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学] R657.42[医药卫生—临床医学]