腹腔镜联合胆道镜保胆取石术治疗胆囊结石78例报告  

Laparoscopic combined with choledochoscopic gallbladder-preserving cholecystolithotomy in the treatment of cholecystolithiasis:with a report of 78 cases

作　　者：张威[1] 王英超[1] 付裕[1] 刘松阳[1] 刘凯[1] 纪柏[1] 蒋培强[1] 宋俊年[1] 刘亚辉[1] 

机构地区：[1]吉林大学白求恩第一医院,吉林长春130021

出　　处：《腹腔镜外科杂志》2014年第9期690-692,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜联合胆道镜行保胆取石术治疗胆囊结石的适应证、手术方法及临床价值。方法:回顾分析2009年1月至2014年5月为78例胆囊结石患者行腹腔镜联合胆道镜保胆取石术的临床资料。结果:78例均顺利完成手术,手术时间平均(35±15)min,术中出血量平均(15±7)ml,术后患者8 h即可离床活动,次日进流质饮食,术后平均(4.0±1.2)d出院。术后均无出血、胆漏、切口感染等并发症发生。经过随访,仅1例复发,复发率1.28%。结论:腹腔镜联合胆道镜行保胆取石术具有微创、并发症少、复发率低等优点,在严格掌握适应证及精细操作的前提下,手术是安全、可行的。Objective： To investigate the indications,operative methods and clinical value of laparoscopic combined with choledochoscopic gallbladder-preserving cholecystolithotomy in the treatment of cholecystolithiasis. Methods： Clinical data of 78 patients who suffered from cholecystolithiasis and underwent laparoscopic combined with choledochoscopic gallbladder-preserving cholecystolithotomy from Jan. 2009 to May 2014 were retrospectively analyzed. Results： All the 78 cases were successful in cholecystolithotomy. The mean operating time was（ 35 ± 15） min,the mean blood loss was（ 15 ± 7） ml. All patients could take normal activity only 8 h after operation,had liquid diet on the first day after operation,and postoperative hospital stay was（ 4. 0 ± 1. 2） d. There were no postoperative complications,such as hemorrhage,bile leakage or incision infection. Only 1 case（ 1. 28%） of recurrence was found during follow-up.Conclusions： Laparoscopic combined with choledochoscopic gallbladder-preserving cholecystolithotomy in the treatment of cholecystolithiasis is minimally invasive,safe and feasible,with few complications and low incidence of recurrence on the premise of strict mastering indications and refined manipulation.

关 键 词：胆囊结石病 腹腔镜检查 胆道镜检查 保胆取石术 

分 类 号：R657.4[医药卫生—外科学]