腹腔镜、胆道镜、胃镜三镜联合治疗胆囊结石合并胆总管结石的临床应用(附30例报告)  

Clinical application of laparoscope with choledochoscope and gastroscope in treatment of cholecystolithiasis combined with choledocholithiasis: with a report of 30 cases

作　　者：李英俊[1] 

机构地区：[1]新泰市人民医院,山东新泰271200

出　　处：《腹腔镜外科杂志》2014年第6期451-453,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜胆囊切除（laparoscopic cholecystectomy，LC）、胆总管探查＋术中胃镜辅助放置鼻胆管引流、胆总管一期缝合术治疗胆囊结石并胆总管结石的临床应用价值。方法：回顾分析2011年6月至2013年7月为30例患者行LC＋胆道镜胆总管探查＋术中胃镜辅助放置鼻胆管引流＋胆总管一期缝合术的临床资料。结果：30例手术均获成功，无一例中转开腹。手术时间110～160min，平均（137±19）min；术中出血量30～80ml，平均（56±16）ml；术后肠功能恢复时间24—48h，平均（40±8）h；术后无严重并发症发生；术后住院7—9d，平均（8±1）d。随访3—28个月，平均（17±8）个月，未发现胆总管狭窄或结石残留。结论：腹腔镜联合胆道镜、胃镜是治疗胆囊结石合并胆总管结石的合理术式，具有安全、有效、微创、保留Oddi括约肌功能等优点，患者术后康复快，具有临床推广价值。Objective：To investigate the value of clinical use of laparoscopic cholecystectomy together with choledochoscopic common bile duct exploration and intraoperative gastroscopy-assisted nasobiliary drainage and primary suture of common bile duct in treatment of cholecystolithiasis combined with choledocholithiasis. Methods ： The clinical data of 30 patients who underwent laparoscopic cholecystectomy together with choledochoscopic common bile duct exploration and intraoperative gastroscopy-assisted nasobiliary drain age and primary suture of common bile duct from Jun. 2011 to Jul. 2013 were retrospectively analyzed. Results：The surgery was successfully performed in all cases and no case was converted to laparotomy. The mean operative time was （137 ± 19） min （range, 110- 160 min）. The mean amount of hemorrhage during operation was （56 ± 16） ml （ range,30-80 ml）. The mean recovery time of gastrointestinal function was （40 ± 8 ） h （range,24-48 h） after operation. There were no serious postoperative complications, and the mean hospital stay was （ 8 ± 1 ） d （ range,7-9 d）. The mean follow-up of the patients for （ 17 ± 8） months （ range,3-28 months） showed no common bile duct stricture or retained stones. Conclusions：Laparoscope with choledochoscope and gastroscope is the available operation to treat cholecystolithiasis combined with choledocholithiasis. The procedure is safe, effective and mini-invasive with rapid recovery and preserves the Oddi sphincter,and is worth to be popularized in clinic.

关 键 词：胆总管结石 胆囊结石病 腹腔镜检查 胆道镜检查 胃镜检查 

分 类 号：R657.4[医药卫生—外科学]