腹腔镜胆总管探查手术适应证的探讨  

Discussion on indications of laparoscopic common bile duct exploration

作　　者：张天华[1] 曾鹏飞[1] 

机构地区：[1]遵义医学院第三附院肝胆外科,贵州遵义563002

出　　处：《中国内镜杂志》2009年第12期1288-1289,共2页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜胆总管探查术(LCBDE)的手术适应证及其临床疗效。方法总结分析该院2007年1月～2009年3月成功开展腹腔镜胆囊切除术联合纤维胆道镜胆总管探查术103例患者的临床资料。结果88例成功,中转开腹15例。10例因术中明确肝内胆管结石残留,留置T管。3例术后经ENBD管造影发现胆管残留结石,使用十二指肠镜取石成功。结论胆囊结石及胆囊炎合并胆管结石是腹腔镜胆总管探查取石术的最佳手术适应证。[Objective] To investigate and summarize the indications and clinical therapeutic effect of laparoscopic common bile duct exploration. [Methods] The clinical data of 103 cases, who successfully received laparoscopic cholecystectomy and laparoscopic common bile duct exploration from January 2007 to March 2009, were summarized. [Results] In 103 eases, the operations in 88 eases were sueeessful. Fifteen eases were converted to laparotomy. Ten cases were converted to T-tube drainage because of the residual stones found in ihtrahepatic bile ducts in operation. Three cases were found to have the residual bile duct stones on postoperative cholangiogram through ENBD-tube, which were successfully removed by postoperative endoscopic therapy. [Conclusion] Cholecystolithiasis and eholeeystitis with calculi of bile duct are the best indications of the laparoscopie cholecystectomy-bile duct exploration.

关 键 词：腹腔镜 胆道镜 胆总管探查术 胆总管结石 

分 类 号：R657.42[医药卫生—外科学]