内镜联合腹腔镜治疗胆囊合并胆总管结石  

Laparoscopy combined with duodenoscopy for treatment of gallbladder and bile duct stones

作　　者：谢建平[1] 辜天慧[1] 

机构地区：[1]巴中市中心医院肝胆外科,四川巴中636000

出　　处：《四川医学》2011年第9期1447-1449,共3页Sichuan Medical Journal

摘　　要：目的探讨十二指肠镜下行乳头切开取石术(EST)联合腹腔镜行腹腔镜胆囊切除术(LC)。方法自2007年4月～2010年6月以来我院B超或ERCP诊断为胆囊合并胆总管结石的70例患者,胆总管结石直径<1.0cm,结石为1～2枚49例2,枚以上21例。用针刀或弓刀行乳头预切开,在X线透视下用取石网或气囊取石。术后3～4d行腹腔镜胆囊切除术(LC)。结果全组70例患者67例成功行十二指肠镜下行乳头切开取石术(EST)联合腹腔镜胆囊切除术(LC)。术后胆总管残留结石3例,术后并发轻型胰腺炎5例,乳头出血1例,无胆管感染,LC术后无并发症发生。平均住院日(10±3)d。结论十二指肠镜下逆行胰胆管造影(ERCP)及乳头切开取石术+腹腔镜胆囊切除术(LC)在治疗胆囊合并胆总管结石是安全有效微创手术方式。Objective The discussion of Endoscopic duodenal papilla incision line（EST） with Laparoscopic laparoscopic cholecystectomy（LC）.Methods 70 patients were diagnosed with Gallbladder and common bile duct stones by B-ultrasound or ERCP in our hospital from 2007.4 to 2010.6,the diameter of common bile duct stones is less than 1.0cm,there are 49 cases have 1-2 pieces of stone,while 21 cases are above 2pieces.Line with a knife or bow knife pre-cut the nipple,under X-ray net or air bag with stone stone.The LC would be operated 3-4 days after the surgery.Results The overall success of 67 cases of 70 patients duodenal endoscopy in the nipple line incision（EST） combined with laparoscopic cholecystectomy（LC）.Postoperative residual common bile duct stones in 3 cases,postoperative pancreatitis light 5,nipple bleeding in 1 case,and no biliary tract infection,LC were no complications after the surgery.The average time of stay in hospital is（10 ± 3）d.Conclusion ERCP and LC is safe and effective minimally invasive in the treatment of gallbladder and common bile duct stones side.

关 键 词：内镜下逆行胰胆管造影(ERCP) 乳头括约肌预切开术(EST) 腹腔镜胆囊切除术(LC) 胆囊结石 胆总管结石 

分 类 号：R657.42[医药卫生—外科学]