腹腔镜联合十二指肠镜治疗胆囊结石合并胆总管结石效果分析  

Effect of combined laparoscopic treatment of gallstone duodenoscope on common bile duct stones

作　　者：韩延亮[1] 安永男[1] 闫俊凤[1] 王长杰[1] 许焕才[1] 

机构地区：[1]牡丹江医学院第二附属医院普外科,牡丹江157000

出　　处：《国际外科学杂志》2010年第8期508-511,共4页International Journal of Surgery

摘　　要：目的 探讨腹腔镜胆囊切除术（LC）联合内镜Oddi括约肌切开取石术（EST）治疗胆囊结石合并胆总管结石的临床效果.方法 回顾性分析2003年5月-2009年6月,LC与EST联合治疗胆囊结石合并胆总管结石78例临床资料.首先经EST取出胆管结石,5 d内行LC.结果 EST成功76例（97%）,失效2例,1例因胆管末端狭窄,开腹行胆肠吻合术治愈;1例胆总管结石直径1.6 cm,质硬,机械性碎石失败,开腹行胆总管切开取石T管引流术.76例腹腔镜手术成功,无明显出血、胆漏等严重并发症.结论 EST＋LC联合治疗胆囊结石并胆总管结石具有创伤小、恢复快、并发症少及无需T管引流等优点,是一种安全有效的治疗方法.Objective To study the effect of laparoscopic cholecystectomy endoscopic sphincterotomy combined with Oddi lithotomy （EST） treatment of gallbladder stone on common bile duct stones. Methods A retrospective analysis between May 2003 and June 2009 ,the combined treatment of LC and EST in 78 patients with common bile duct stones was retrospectivelly analyzed. First, bile duct stones were removed by EST, then laparoscopic cholecystectomy was performed within 5 days. Results EST was performed successfully in 76 cases （97%）, failure in 2 cases, 1 case abdominal choledochojejunostomy due to the end of bile duct stenosis; one cases of common bile duct stone diameter of 1.6 cm, firm, failure of mechanical lithotripsy received common bile duct ploration T-tube drainage 76 cases of laparoscopic operation is successful, without obvious bleeding, bile leakage and other severe complications. Conclusions The advantages of EST ＋ LC for the gallbladder stones and common bile duct stones with less trauma, faster recovery, fewer complications, and no T-tube drainage, etc; this is a safe and effective treatment.

关 键 词：胆囊结石 腹腔镜胆囊切除术 Oddi括约肌取石术 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]