细导管胆道引流在微创治疗肝外胆管结石中的应用  

Use of ureteral catheter for bile duct drainage in minimally invasive treatment of extrahepatic bile duct stones

作　　者：管辉球[1] 丁明金[1] 赵国栋[1] 

机构地区：[1]南通大学附属丹阳医院丹阳市人民医院普通外科,江苏省212300

出　　处：《中华普通外科杂志》2015年第11期900-902,共3页Chinese Journal of General Surgery

摘　　要：目的评价经胆囊管置细导管（输尿管导管）胆道引流在腹腔镜胆总管探查一期缝合及腹腔镜术后内镜取石治疗肝外胆管结石中的应用价值。方法回顾性分析116例经输尿管导管胆道引流在治疗肝外胆管结石中的临床资料。按治疗方式将患者分为2组，A组：胆总管扩张患者57例，腹腔镜胆囊切除＋胆总管探查一期缝合＋经胆囊管置输尿管导管胆道引流；B组：胆总管无扩张患者59例，腹腔镜胆囊切除＋经胆囊管置输尿管导管胆道引流＋术后内镜取石。结果2组患者均顺利完成手术，患者术后无胰腺炎、胆漏等并发症。A组患者术后6～9d拔管，术后住院时间（8．5±2）d；B组患者内镜取石术后2～8d拔管，术后住院时间（7．6±3）d。2组患者均无拔管并发症。结论经胆囊管置输尿管导管胆道引流，在腹腔镜胆总管探查一期缝合及腹腔镜术后内镜取石治疗肝外胆管结石中的应用，能有效地预防术后可能发生的胰腺炎、胆漏、胆管狭窄等并发症，对内镜治疗的操作有很好的帮助作用。Objective To evaluate bile duct drainage with ureteral catheter through cystic duct in laparoseopie common bile duct exploration followed by primary duct closure （LCBDEPDC） and posto laparoscopic endoscopic stone extraction treatment of extrahepatie bile duct stones. Methods The clinical data of 116 cases of extrahepatic bile duct stones were retrospectively analyzed. Patients were divided into 2 groups： 57 patients with dilated common bile duct were in group A treated with laparoseopic common bile duct exploration followed by primary duct closure and via cystic duct ureteral catheter biliary drainage. While in group B （59 patients） with normal calibre of the common bile duct, the procedures was laparoscopic cholecysteetomy ＋ via cystic duct ureteral catheter biliary drainage and postoperative endoscopic stone extraction. Results Procedures were successful in both the two groups. There was no postoperative pancreatitis and biliary leakage complications. The catheter was withdrawn in 6 -9 d in group A postoperative hospitalization time was （ 8.5 ± 2 ） d. The catheter was withdrawn in 2 - 8 d in group B after endoscopic stone extraction. Postoperative hospitalization time was （7.6± 3 ） d. No complications occurred in both two groups relating extubation. Conclusions Bile duct drainage using the ureteral catheter via cyst duct after LCBDEPDC and endoscopic stone extraction treatment of extrahepatic bile duct stones effectively prevent postoperative pancreatitis, biliary leakage and bile duct stricture.

关 键 词：胆结石 腹腔镜 引流术 

分 类 号：R657.4[医药卫生—外科学]