不带T管腹腔镜胆总管探查术  

Laparoscopic exploration of common bile duct without T tube

作　　者：李美荣[1] 陈伟强[1] 吴桂堂[1] 张锐江[1] 向王洛平[1] 郑进洪[1] 

机构地区：[1]广东医学院附属陈星海医院普外科,广东中山528415

出　　处：《中国内镜杂志》2011年第9期971-973,共3页China Journal of Endoscopy

摘　　要：目的探讨不带T管保留Oddi括约肌功能腹腔镜胆总管探查术的治疗方法及效果。方法对38例胆囊结石并胆总管结石的患者,个体化采用腹腔镜下行经胆囊管胆总管取石后缝扎胆囊管(n=5)、胆囊切除胆总管切开探查取石术后胆总管一期缝合(n=10)、胆囊切除胆总管切开探查取石术后胆总管一期缝合加术中留置鼻胆管引流(n=11)、胆囊切除胆总管切开探查取石术辅助小切口原位缝合并肝圆韧带局部缝合加固及术中鼻胆管引流术(n=5)、胆囊切除胆总管切开探查取石术辅助小切口下胆道扩张并鼻胆管引流再一期缝合手术(n=7)治疗,并对上述治疗方法加以分析。结果全组病例无围手术期死亡、术后胆漏及胆道残余结石发生。结论对胆总管结石患者采取个体化选择手术适应证行不带T管的腹腔镜胆道探查术是科学合理的手术治疗方式。[Objective] To explore the therapeutic methods and efficacy of laparoscopic exploration of common duct reserving oddi sphincter function without T tube.[Methods] To analyze 38 cases of common bile duct stone and gallstone patients accepted individual methods of laparoscopy exploration of common bile duct and laparoscopic cholecystectomy：five cases accepted ductus cysticus transfixion after calculus removed via ductus cysticus;ten cases accepted choledochus primary suture;eleven cases accepted choledochus primary suture and placed nasobiliary drainage;five cases accepted choledochus situ suture and ligament teres suture and nasobiliary drainage;seven cases accepted situ suture after placed nasobiliary drainage under laparoscopic-assisted small incision.[Results] All of the patients were no preoperative death,postoperative bile leakage and residual stone occurred.[Conclusion] It is scientific and reasonable way that laparoscopic exploration of common duct without T tube for the choledocholithiasis patients of individual selected surgery indication.

关 键 词：腹腔镜 胆总管探查术 一期缝合 

分 类 号：R657.4[医药卫生—外科学]