腹腔镜胆道镜十二指肠镜联合治疗原发性肝管结石31例报告  

COMBINATION OF LAPAROSCOPY,CHOLEDOCHOSCOPY AND DUODENOSCOPY FOR TREATMENT OF PRIMARY BILE DUCT STONES——REPORT OF 31 CASES

作　　者：陈安平[1] 田刚[1] 宋安宁[1] 易斌[1] 李清亮[1] 李涛[1] 

机构地区：[1]四川省成都市第二人民医院,610017

出　　处：《中国内镜杂志》2001年第3期42-43,45,共3页China Journal of Endoscopy

摘　　要：目的 :探讨三镜联合治疗原发性肝胆管结石和肝胆管狭窄的手术方法 ,提高治愈率和避免多次开腹手术。方法 :采用腹腔镜、胆道镜、十二指肠镜 (三镜 )联合治疗原发性肝胆管结石 31例。经十二指肠镜手术治疗肝外胆管尤其是胆总管下端结石及狭窄。经腹腔镜手术行胆囊切除 (LC)及结合胆道镜行肝胆管探查术(LCDE)和耐高压球囊导管扩张术 (LPBD) ,解除肝门部胆管梗阻及狭窄。术后 2月行胆道镜和 /或十二指肠镜治疗残余结石及肝内外胆管内支撑引流术。结果 :31例均获成功 ,未再施行开腹手术 ,经IVC和ERCP随访 30例结石取净 ,1例左外叶肝管残石。结论 :病例选择恰当 ,三镜联合治疗原发性肝胆管结石具有创伤小、结石除净率高 。Objective:To study the methods of combination of multiple endoscopies for the treatment of special primary bile duct stones.Methods:31 Patients were admitted to receive the procedures,i.e.endoscopic sphincterotomy,mechanical lithothipsy,nasobiliary drainage(duodenoscopy) was first adopted,then followed by laparoscopic CBD exploration(choledochoscopy) and Vas-Cath Centurion dilatation to treat the papillary stenosis and the hepatic port duct stenosis and clear stones.Postoperative choledochoscopic and duodenoscopic removal of bile duct residual stones and EST\EPBD were recommended for retained bile duct stones or papillary stenosis.Results:Satisfatory outcome was obtained,neigher conversion,nor serious side-effect observed.Time taken for the endoscopies remained same as that for open choledocholithotomy and choledochojejunostomy,while postoperative hospital stay reduced obviously than the latter.Conclusions:The combined endoscopices is practicable and safe,and able to substitue for some open choledocholithotomy and choloedochojejunostomy.

关 键 词：腹腔镜 胆道镜 十二指肠镜 结石 狭窄 球囊 治疗 

分 类 号：R574.510.5[医药卫生—消化系统]