腹腔镜胆总管探查术中十二指肠镜下乳头狭窄切开术91例报道  

Duodenoscopic papillotomy during the course of laparoscopic common bile duct exploration:a report of 91 cases

作　　者：李波[1] 陈安平[1] 索运生[1] 刘安[1] 易斌[1] 王征夏[1] 肖宏[1] 陈先林[1] 龙飞伍[1] 孙科[1] 

机构地区：[1]成都市第二人民医院肝胆胰外科,成都610017

出　　处：《中华腔镜外科杂志（电子版）》2010年第5期49-53,共5页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜胆总管探查术中十二指肠镜下乳头狭窄切开术(LEST)治疗十二指肠乳头狭窄的手术方法和适应证。方法 2000年9月至2010年4月,91例患者接受腹腔镜胆囊切除、胆总管切开和胆管镜探查取石术,经胆总管切口插入输尿管导管或斑马导丝至十二指肠肠腔,经口插入十二指肠镜至十二指肠乳头,针式刀在输尿管导管或斑马导丝的引导下行乳头切开术。结果施行LEST91例,86例乳头狭窄切开成功,5例中转为其他术式。术后轻症胰腺炎2例。无肠穿孔、胆管穿孔、胆漏、大出血、重症胰腺炎等并发症发生,无死亡病例。结论只要选择合适的病例,LEST是可行、有效和安全的。Objective To explore the operation methods and indications of duodenoscopic papillotomy during the course of laparoscopic common bile duct exploration （ LEST ）. Methods From September 2000 to April 2010,91 patients accepted laparoscopic cholecystectomy and common bile duct exploration by choledochoscopy firstly, through ureteric catheter and zebra guidewire of common bile duct incision into duodenum, through duodenoscopy via oral into the papillary of duodenum, were used to cut through the stenosis of papillary for electro-knife by pin-head-like to track along the ureteric catheter and zebra guidewire. Results LEST was successful in 86 out of 91 cases. Five cases were shifted to other operation. Two patients were a slight pancreatitis. No cases had perforation of intestine and bile duct, bile leakage, bleeding, severe pancreatitis and death. Conclusions If patients are suitable, LEST is safe and effective.

关 键 词：腹腔镜 胆管镜 十二指肠镜 乳头切开术 

分 类 号：R657.4[医药卫生—外科学]