腹腔镜胆囊切除术中十二指肠镜下乳头切开取石术202例报告  

Duodenoscopic papillotomy during the course of laparoscopic cholecystectomy:a report of 202 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]四川省成都市第二人民医院肝胆胰外科,四川成都610017

出　　处：《中国内镜杂志》2011年第4期400-403,406,共5页China Journal of Endoscopy

摘　　要：目的总结运用腹腔镜胆囊切除术中十二指肠镜下乳头切开取石术(LECT)治疗胆囊结石继发胆总管结石的临床经验。方法腹腔镜下行胆囊切除术,经胆囊管残端插入输尿管导管或斑马导丝至十二指肠腔,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指引下对乳头施行切开术,用十二指肠镜取石网或球囊取石。结果施行LECT202例,乳头切开取石179例,乳头切开排石17例,中转为其他术式6例。术后轻症胰腺炎9例,残留结石4例。无肠穿孔、胆管穿孔、胆漏、大出血、重症胰腺炎等并发症,无死亡病例。结论只要选择合适的病例,LECT是可行、有效和安全的。[Objective] To summarize the clinic experience that the stones of gall bladder along with common bile duct cured with duodenoscopic papillotomy during the course of laparoscopic cholecystectomy （LECT）.[Methods] To accomplish cholecystectomy,through ureteric catheter and zebra guidewire of cholecystic duct remnant into the common bile duct and 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,to clear the stones of the common bile duct with the reticulation and the balloon of duodenoscopy.[Results] LECT was performed on 202 cases.The stones of common bile duct removed with duodenoscopic papillotomy had 179 cases,the stone expulsion after duodenoscopic papillotomy had 17 cases,six cases were shifted to other operation.Nine cases were a slight pancreatitis after operation,four cases were residual stones then no cured during hospitalization and follow-up examination.No cases had perforation of intestine and bile duct,bile leakage,bleeding,severe pancreatitis and death.[Conclusion] If patients are suitable,LECT is safe and effective.

关 键 词：腹腔镜 十二指肠镜 乳头切开术 胆结石 

分 类 号：R657.42[医药卫生—外科学]