腹腔镜联合胆道镜在治疗胆总管结石术中的应用(附33例报告)  

Experience of laparoscope combined hard ureteroscope in treatment of patients with choledocholithiasis(report of 33 cases)

作　　者：莫琰[1] 周学鲁[1] 胡灏[1] 张继峰[1] 周上军[1] 张剑锋[1] 蔡伟斌[1] 占平[1] 

机构地区：[1]广东中医药大学附属东莞市中医院外科,523127

出　　处：《中国医疗前沿》2013年第11期41-42,共2页China Healthcare Innovation

摘　　要：目的探讨腹腔镜联合硬性输尿管镜治疗胆总管结石术中的应用体会和常见并发症防治。方法回顾分析我院2008年3月-2012年10月间33例腹腔镜下输尿管镜弹道碎石患者的临床资料。结果 32例腹腔镜下完成手术,手术时间80-240min,术中出血60-300ml。所有腔镜手术患者均放置"J"形内引流管,并I期缝合胆总管。"J"管6-8d后通过胃镜取出。1例患者因术中胆总管出血中转开腹,术后轻微胆漏1例,经持续腹腔引流2周后治疗痊愈。住院时间8-12d。平均随访40个月,患者无腹痛、寒热往来、黄疸等症状。未见结石复发。结论腹腔镜联合硬性输尿管镜弹道碎石在胆总管结石治疗的微创术式可行、安全、有效。Objective To report our experience and analyze complications in treatment of patients with choledocholithiasis via laparoscope combined hard ureteroscope.Methods From March 2008 to October 2012,33 patients underwent minimally invasive surgery for symptomatic common bile duct gallstones.The clinical date was retrospectively analyzed.Results 32 cases were successful underwent by laparoscope and ureteroscope.The operation time was 80-240min,blood loss was 60-300ml.T tube drainage was substituted by endobiliary drainage of ‘J’ tube and the common bile duct was primarily closed after laparoscopic common bile duct exploration.‘J’ tube was take out after 6-8d via gastroscope.1 case was transferred to laparotomy because of bile duct bleeding.The average hospital stay was 8-12d.Follow-up time was 40m.There was no evidence of recurrence of gallstone.Conclusion Minimally invasive surgery of laparoscope combined ureterosopce in treatment of cholelithiasis and choledocholithiasis is feasible,efficacy and safe.

关 键 词：腹腔镜 硬性输尿管镜 弹道碎石 肝总胆管结石 

分 类 号：R657.42[医药卫生—外科学]