腹腔镜经胆囊管开口微切开胆管并一期缝合胆管治疗胆囊结石合并胆管结石  

Laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration using a mini in- cision and primary suturing of the bile duct in the treatment of gallbladder and common bile duct stones

作　　者：罗昆仑 方征 余锋 刘洪 田志强 

机构地区：[1]解放军第一〇一医院肝胆外科南京军区腹腔镜外科中心,无锡214044

出　　处：《中华肝胆外科杂志》2013年第5期349-351,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨改进腹腔镜下治疗胆囊结石合并胆管结石的手术方式，以期提高腹腔镜治疗胆囊结石合并胆管结石的成功率。方法对60例胆囊结石合并胆管结石的患者，行腹腔镜胆囊切除及经胆囊管开口微切开胆管探查取石并一期缝合胆管（简称LcTDE）术。结果全组60例，均成功采用LcTDE。胆管内取出单一结石32例，2～6枚结石28例。手术时间（38．7±15．1）min，住院时间（5．5±2．1）d。术后出现胆瘘1例，引流7d后无胆汁渗漏，拔除引流管，痊愈出院。术后1个月发现胆管残留结石1例，经内镜逆行胆胰管造影取出结石，痊愈。其余病例无胆管狭窄、胆管残留结石及其他手术并发症发生。结论LcTDE术具有手术时间短、术式简单易行、术后胆漏少且易控制的特点，是胆囊合并胆管结石很好的微创治疗方法。Objective To study the results of laparoscopic approach in the treatment of gallblad- der and common bile duct stones. Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically. Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration （LcTDE） were successful. There were 1 bile duct stone in 32 patients, and 2 to 6 bile duct stones in 28 patients. The operation time was （38.7±15.1） min and the hospitalization time was （5.5±2.1） days. One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment. One patient had bile duct residual stone which was treated by ERCP. The remaining patients were well. Conclusion Lapa- roscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple, safe and efficacious.

关 键 词：胆结石 胆道外科手术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]