两镜联合微创保胆取石术治疗胆囊颈部结石嵌顿的临床体会  

The experience of gallbladder-preserving cholelithotomy for calculus incarcerated in neck of gallbladder by two endoscopes

作　　者：叶锡银 王三贵 张小玲 张宝善[2] 

机构地区：[1]东莞市南城人民医院,广东东莞523071 [2]北京大学第一医院

出　　处：《腹腔镜外科杂志》2011年第7期514-516,共3页Journal of Laparoscopic Surgery

摘　　要：目的:总结胆囊颈部结石嵌顿行两镜联合微创保胆取石术的临床体会。方法:回顾分析2008年3月至2010年3月为73例胆囊颈部结石嵌顿患者施行两镜联合手术的临床资料。结果:51例一次性保胆取石成功;18例行胆囊造瘘术,其中17例Ⅱ期经瘘道胆道镜胆囊探查成功保胆,1例因术后一直无胆汁,胆囊无功能,Ⅱ期施行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC);4例因术中合并胆囊管中段嵌顿性结石致胆囊管不通施行LC。本组均无并发症发生,无结石复发。结论:两镜联合保胆取石术治疗胆囊结石嵌顿成功率高,患者创伤小,安全可行。Objective：To investigate the method of mini-invasive gallbladder-preserving cholelithotomy for calculus incarcerated in neck of gallbladder by two endoscopes.Methods：The clinical data of 73 patients who suffered from calculus incarcerated in neck of gallbladder and underwent choledochoscopy and laparoscopy since Mar.2008 to Mar.2010 were analyzed retrospectively.Results：The 51 operations were finished successfully.18 cases were treated with gallbladder fistulization,of them,17 cases underwent trans-fistula gallbladder exploration on the secondary operation.1 case without bile and gallbladder function was treated with laparoscopic cholecystectomy（LC） after operation;4 cases were treated with LC because of the calculi incarcerated in the middle cystic duct and the bile duct was obstructed.No complications happened and no calculus recurred.Conclusions：The gallbladder-preserving cholelithotomy for calculus incarcerated in neck of gallbladder by two endoscopes is mini-invasive,safe and feasible with high achievement rate.

关 键 词：胆囊结石病 嵌顿 胆道镜检查 腹腔镜检查 保胆取石术 

分 类 号：R657.4[医药卫生—外科学]