老年患者胆囊结石合并胆总管末端嵌顿性结石微创治疗——附35例报告  

Minimally Invasive Treatment of Senile Patients with Cholecystolithiasis and Choledochal Duct Terminal Incarcerated Stones——Report of 35 Cases

作　　者：郭晓明[1] 徐涵[1] 王洋[1] 辛民志[1] 

机构地区：[1]北京市延庆区医院(北京大学第三医院延庆医院)普外科,北京102100

出　　处：《中外医疗》2017年第17期106-108,共3页China & Foreign Medical Treatment

摘　　要：目的探讨腹腔镜下胆道镜联合液电碎石在治疗老年患者胆囊结石胆总管末端嵌顿性结石的安全性和疗效。方法回顾分析该院2010年1月—2015年10月,在腹腔镜下行LC+胆道镜联合液电碎石治疗35例胆囊结石合并胆总管下端嵌顿性结石的老年患者。采用单次脉冲模式,输出能量0.15 J,放电导线通过胆道镜工作通道,在直视下接触结石,将结石击碎后注水冲出或通过取石篮取出。结果 35例患者结石均完全清除,其中34例均在腹腔镜下顺利完成手术,1例中转开腹。35例患者得到随访,随访6个月~5年,未见结石复发及胆道狭窄。结论 LC+腹腔镜下胆道镜联合液电碎石具有直观、准确、疗效确切的特点,对于治疗老年患者胆囊结石合并胆总管下段嵌顿性结石是安全、有效的手段。Objective To study the safety and curative effect of minimally invasive treatment of senile patients with cholecystolithiasis and choledochal duct terminal incarcerated stones. Methods 35 cases of senile patients with cholecystolithiasis and choledochal duct terminal incarcerated stones treated with laparoscopic LC and choledochoscope and electrohydraulic shockwave lithotripsy from January 2010 to October 2015 were retrospectively analyzed and the patients adopted the single impulse mode and the output energy was 0.15 J, and the electrical circuitry discharge wire was exposed to stones by the choledochoscope work passage, and the stones were washed out or taken out. Results The stones of 35 cases were totally cleared, and 34 cases finished the operation under the laparoscope and 1 case was converted to laparotomy, and 35 cases of patients were followed up for 6 months to 5 years, and there was no stone recurrence or biliary stricture. Conclusion The LC and laparoscopic choledochoscope and electrohydraulic shockwave lithotripsy is intuitive and accurate, and the curative effect is definite, which is a safe and effective means of treatment of cholecystolithiasis and choledochal duct terminal incarcerated stones.

关 键 词：老年患者 腹腔镜 液电碎石 胆总管嵌顿性结石 

分 类 号：R657[医药卫生—外科学]