腹腔镜下经胆囊管途径胆道镜胆总管探查术的临床应用(附32例报告)  

The clinical application of laparoscopic common bile duct exploration with choledochoscope by ductus cysticus-a report of 32 cases

作　　者：王京涛[1] 付云强[1] 刘明明[1] 

机构地区：[1]潍坊市中医院肝胆胰外科,261041

出　　处：《中华腔镜外科杂志（电子版）》2017年第4期235-237,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜下经胆囊管途径行胆道镜胆总管探查取石治疗胆囊胆总管结石的可行性。方法自2008年1月至2013年12月为32例胆囊胆总管结石的患者实施了腹腔镜下经胆囊管途径胆道镜胆总管探查取石术。结果 32例手术均获得成功,术中阴性探查1例,结石取净率为100%;术后并发症:1例患者于术后3 d出现间歇性右上痛,术后6 d时出现轻微黄疸症状,通过保守治疗,术后8 d腹痛缓解,黄疸消退。其他患者无胆漏、黄疸、腹痛及切口感染;术后共随访患者29例,无结石再发或胆管狭窄的发生。结论通过适当的手术患者选择,术者腹腔镜、胆道镜技术的熟练,腹腔镜下经胆囊管途径行胆道镜胆总管探查取石术是安全、可行的。Objective To explore the feasibility of laparoscopic common bile duct exploration with choledochoscope by ductus cysticus for those with gallbladder stones and common bile duct stones.Methods 32 patients with gallbladder stones and common bile duct stones were performed laparoscopic common bile duct exploration with choledochoscope by ductus cysticus from Jan. 2008 to Dec. 2013.Resluts All 32 cases were cured and stone clearance rate was 100% with 1 case had no CBD stone. One patient showed intermittent abdominal pain on day 3 after the surgery, and jaundice on day 6, by conservative therapy,both the symptoms were improved on day 8. Other patients had no biliary leakage,abdominal pain,and choloplania or infection of incision. No calculus regeneration or bile stricture occurred during following-up in the 29 patients. Conclusions With proper patient selection,laparoscopic common bile duct exploration with choledochoscope by ductus cysticus is safe and feasible.

关 键 词：胆囊管 腹腔镜 胆道镜 胆囊结石 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]