腹腔镜、胆道镜、十二指肠镜联合治疗胆囊结石合并胆道结石86例分析  

THE LAPAROSCOPIC,CHOLEDOCHOSCOPE AND DUODENOSCOPY JOINT TREATMENT OF GALLSTONES WITH BILIARY CALCULI EXPERIENCE OF 86 CASES

作　　者：朱坪[1] 朱万喜[1] 李世刚[1] 万强[1] 徐建军[1] 杨楷[1] 李正宗[1] 

机构地区：[1]中国十九冶集团有限公司职工医院,四川省攀枝花市617023

出　　处：《中国煤炭工业医学杂志》2013年第9期1441-1443,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨胆囊结石合并胆道结石的个体化治疗方法。方法根据各种不同的情况选择:①LC+腔镜下经胆囊管胆道取石;②LC+腔镜下胆总管切开取石+T管引流;③ENBD+LC+腔镜下胆总管切开取石+胆总管一期缝合。结果本组86例,经胆囊管途径取石12例;腹腔镜胆总管探查取石或蛔虫、T型管引流64例,其中术后胆道残余结石3例,经胆道镜1次或数次取尽结石;腹腔镜胆总管切开探查取石、鼻胆管引流、胆总管一期缝合10例,手术全部取得成功。结论根据手术前患者彩超,腹部CT,胆道造影结果,选择二镜或三镜联合的方式治疗胆囊合并胆道结石,治疗效果安全可行,个体化的治疗原则保证了让大多数患者得到适合的微创治疗。Objective To explore the individualized treatment of gallstones with biliary stones. Methods All subjects were selected according to various condition, included LC ＋ endoscopic stone through the cyst- ic duct biliary, LC＋ laparoscopic common bile duct stone ＋ T - tube drainage, ENBD ＋ LC ＋ laparo- scopic common bile duct take stone ＋ common bile duct a suture. Results The group of 86 cases, 12 cases for the cystic duct pathway stone; 64 cases for the laparoscopic common bile duct exploration or roundw- orms and T -tube drainage, including three cases of postoperative biliary residual stones choledochoscope once or several times to take the best stones; 10 cases for the laparoscopic common bile duct exploration stone, the ENBD common bile duct a suture. All of the surgical were success. Conclusions According to the results of ultrasonography, abdominal CT and cholangiography before surgery, two mirror or endo- scopic treatment of gallbladder with biliary stones is a safe and feasible therapeutic schedule, individualized treatment principles will to be ensure a m^nimally invasive treatment for most patients to get fit.

关 键 词：胆囊结石 胆道结石 腹腔镜 胆道镜 十二指肠镜 

分 类 号：R657.42[医药卫生—外科学]