两镜联合治疗胆囊结石合并胆总管结石25例  

Analysis on Combined Duodenoscopy and Laparoscopy in Treating 25 Patients with Cholecystolithiasis and Choledocholithiasis

作　　者：王怀明[1] 折占飞[1] 杨哲[1] 杨秀峰[1] 李咏梅[2] 

机构地区：[1]鄂尔多斯市中心医院普通外科,内蒙古鄂尔多斯017000 [2]鄂尔多斯市中心医院消化内科,内蒙古鄂尔多斯017000

出　　处：《医学综述》2015年第3期554-555,共2页Medical Recapitulate

摘　　要：目的总结十二指肠镜联合腹腔镜（两镜）治疗胆囊结石合并胆总管结石患者的经验。方法选择2008年11月至2011年10月鄂尔多斯市中心医院收治的胆囊结石合并胆总管结石患者25例,均首先行内镜逆行胰胆管造影（ERCP）＋十二指肠镜乳头括约肌切开（EST）,之后行腹腔镜胆囊切除术（LC）,统计两镜联合治疗效果。结果两镜联合取石成功率为96%,随访7~20个月,未见胆总管结石残留和胆管炎发生。结论 ERCP＋EST后行LC是治疗胆囊结石合并胆总管结石的可靠方法,患者恢复快,避免了胆总管切开及T管引流,临床应用价值高。Objective To summarize experiences in treating patients with cholecystolithiasis and choledocholithiasis by duodenalendoscopy combined with laparoscopy. Methods Twenty five patients with cholecystolithiasis and choledocholithiasis admitted in Ordos Central Hospital from Nov. 2008 to Oct. 2011 were selected,patients were treated firstly with endoscopic retrograde cholangiopancreatography（ ERCP） and endoscopic papilla sphincterotomy（ EST）,then with laparoscopic cholecystectomy（ LC）. The curative effect of the combined treatment was analyzed. Results The success rate of stone removal by the combined treatment was96%. Patients were followed up for 7-20 months,with no stone residual found in common bile duct and no incidence of cholangitis. Conclusion LC conducted after combined treatment of ERCP ＋ EST is a reliable treatment for patients with cholecystolithiasis and choledocholithiasis,it results in better and quicker recovery and avoids the common bile duct surgery and the ＂ T＂ tube drainage. Therefore,it is worth promoting widely due to its high clinical value.

关 键 词：胆囊结石 胆总管结石 腹腔镜 十二指肠镜 

分 类 号：R619[医药卫生—外科学] R615[医药卫生—临床医学]