内镜微创保胆取石术中胆管造影的临床意义分析  

Clinical significance of cholangiography in the minimally invasive endoscopic lithotripsy with gallbladder preservation

作　　者：唐民[1] 赵利[1] 易清平[1] 杨红亮[1] 

机构地区：[1]湖南省怀化市中医院,湖南怀化418000

出　　处：《中国内镜杂志》2012年第4期425-427,共3页China Journal of Endoscopy

摘　　要：目的探讨胆管造影在腹腔镜辅助下内镜保胆取石术中的临床意义。方法收集该院56例腹腔镜辅助下内镜保胆取石术中胆管造影患者的资料,对发现有胆总管结石患者的临床资料及术中特点进行归纳分析。结果 56例患者均完成保胆手术,术中胆道造影发现胆总管结石4例(2例小结石,2例泥沙样结石),均为胆囊多发结石或泥沙样结石患者。4例患者中,术中发现胆囊管增粗3例,1例有一过性黄疸病史。4例患者均术中网篮取石成功,篮网取石时间10～18min。所有患者术后无胰腺炎、腹泻、胆漏、出血或心肺等并发症发生。有临床症状者,术后症状均明显缓解或消失。2例出现脂肪液化,经换药后治愈,术后随访6～24个月,新发现3例胆囊复发少量泥沙样结石,服用排石利胆中药半年,复查时结石已排出。结论不仅保胆取石术的适应证需灵活把握,对术中是否予胆管造影同样应灵活把握指征,术中造影对减少术后"复发"具有一定的作用。[Objective] To explore clinical significance of cholangiography in the minimally invasive endoscopic lithotripsy with gallbladder preservation.[Method] All 56 cases of gallstone patients,who received laparoscopic-assisted endoscopic lithotripsy with gallbladder preservation,cholangiography were performed intraoperativly.[Result] 56 cases were successfully performed laparoscopic-assisted endoscopic lithotripsy with gallbladder preservation,2 cases common bile duct stones were found by cholangiography,and stones were removed with cholangioscopy basket.Blood loss was 10～30mL,operation time 30～60 min,an average of 40 min,hospital 3～6 d,4 d average.Patients were followed up 6 to 24 months;three cases were found small sand-like stones relapse,treated with traditional Chinese medicine 1 to 3 months,stones discharged.[Conclusion] Cholangiography has a certain role for reducing postoperative recurrence in the minimally invasive endoscopic lithotripsy with gallbladder preservation.

关 键 词：腹腔镜 保胆 胆结石 胆管造影 胆道镜 

分 类 号：R657.4[医药卫生—外科学]