ERCP联合腹腔镜治疗胆囊结石伴胆总管结石32例临床分析  

The clinical application of the ERCP combined with laparoscopic cholecystectomy for treatment of the cholecystic stone concomitant with choledocholithiasis

作　　者：梁丁保[1] 李向国[2] 徐林生[1] 白云[1] 叶萍[1] 付鑫[1] 齐武[1] 胡炳德[1] 

机构地区：[1]海军安庆医院消化内科,安庆246003 [2]海军安庆医院普外科,安庆246003

出　　处：《安徽医学》2011年第9期1270-1272,共3页Anhui Medical Journal

摘　　要：目的探讨逆行胰胆管造影术（ERCP）联合腹腔镜胆囊切除术（LC）对胆囊结石伴胆总管结石治疗的临床应用。方法 32例胆囊结石伴胆总管结石病变患者,先用ERCP、乳头切开术（EST）取石;或ERCP和鼻胆管引流（ENBD）及柱状气囊扩张术（EPBD）治疗,术后5-14天,患者无发热、腹痛,血淀粉酶正常,再按常规四孔法施行LC。结果 31例（96.9%）成功完成ERCP术。25例行EST术,6例用EPBD,31例置ENBD,2例仅造影诊断。31例胆总管结石全部取尽。31例完成LC术,1例开腹手术。3例（9.3%）ERCP术后急性轻型胰腺炎,无LC和EST相关并发症。结论 ERCP联合腹腔镜对胆囊结石伴胆管病变的治疗,符合外科微创诊治理念,是外科微创术式的可靠选择。Objective Retrograde cholangiopancreatography（ERCP） combined laparoscopic cholecystectomy（LC） for gallbladder stones treated with the clinical application of common bile duct stones.Methods 32 patients with biliary tract disease in patients with gallbladder stones,first with ERCP,sphincterotomy（EST） stone;or ERCP and ENBD（ENBD） and the cylindrical balloon dilatation（EPBD） treatment,after 5 to 14 days,the patient no fever,abdominal pain,serum amylase normal,then conventional four-hole Act LC.Results 31/32 patients（96.9%） successful completed the ERCP surgery.EST 25 patients having surgery,6 patients with the EPBD,31 were home ENBD,2 cases only imaging diagnosis.All 31 cases of bile duct stones were taken to do.LC 31 patients completed surgery,1 case of open surgery.3/32 cases（9.3%） ERCP pancreatitis after acute light,non-LC and EST-related complications.Conclusion ERCP with gallbladder stone Laparoscopic treatment of bile duct lesions,in line with minimally invasive surgical treatment concept is a reliable surgical minimally invasive surgical option.

关 键 词：腹腔镜胆囊切除术 逆行胰胆管造影术 胆囊结石 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]