腹腔镜联合术中胆道镜、十二指肠镜治疗胆囊结石并胆总管结石  

Treatment of Cholecystolithiasis Combined with Calculus of Common Bile Duct by Laparoscopy with Combination of Choledochoscope and Duodenoscope

作　　者：于澜[1] 张抒[1] 黄德全[1] 杨一邨[1] 曹扬[1] 姚欣敏[1] 奚卫东[1] 

机构地区：[1]成都市第三人民医院肝胆研究室,成都610031

出　　处：《中国普外基础与临床杂志》2010年第4期323-325,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结腹腔镜联合术中胆道镜、十二指肠镜治疗胆囊结石并胆总管结石的方法及临床意义。方法我院2007年1月至2008年12月期间采用腹腔镜联合术中胆道镜、十二指肠镜治疗胆囊结石并胆总管结石患者42例,在全麻下行腹腔镜胆囊切除并切开胆总管前壁,以术中胆道镜联合十二指肠镜取净胆总管结石,一期缝合胆总管,并放置鼻胆管引流。结果本组42例患者中1例中转开腹手术,41例成功,术后5～7d拔管出院,无手术死亡病例,无术后漏胆、上消化道出血、穿孔及急性胰腺炎发生。结论腹腔镜联合术中胆道镜、十二指肠镜治疗胆囊结石并胆总管结石,是一种创伤小、恢复快及安全可靠的方法。Objective To investigate the method of the treatment on cholecystolithiasis combined with calculus of common bile duct （CBD） by laparoscopy with combination of choledochoscope and duodenoscope and its significances.Methods Forty-two patients with cholecystolithiasis combined with calculus of CBD were treated by laparoscopy with combination of choledochoscope and duodenoscope from Jan.2007 to Dec.2008 in this hospital.Under general anesthesia,laparoscopic cholecystectomy was performed first,then the anterior wall of CBD was opened,calculus of CBD was treated by choledochoscope and duodenoscope intraoperatively.Then primary suture of the CBD was performed under laparoscope and nasobiliary drainage duct was placed.Results One case was converted to laparotomy,41 cases succeeded and left hospital after being taken off the nasobiliary drainage duct in 5-7 d.No case died,no bile leakage,no bleeding or perforation of upper digestive tract,and no acute pancreatitis happened after operation.Conclusion Laparoscopy with combination of choledochoscope and duodenoscope treating cholecystolithiasis combined with calculus of CBD is a safe,effective and quickly recovering method with less sufferings and trauma.

关 键 词：腹腔镜 胆道镜 十二指肠镜 胆囊结石 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]