无痕腹腔镜胆总管取石、Ⅰ期缝合、保胆取石技术  

Traceless laparoscopy choledocholithotomy,primary closure and cholecystolithotomy with gallbladder preserved

作　　者：张光全[1] 谢亮[1] 吴先麟[1] 郑柳[1] 姚波[1] Zhang Guangquan;Xie Liang;Wu Xianlin;Zheng Liu;Yao Bo(Department of Hepatobiliary Surgery,The Sixth People's Hospital of Chengdu City,Sichuan Province,Sichuan Chengdu 610051)

机构地区：[1]四川省成都市第六人民医院肝胆外科

出　　处：《中国社区医师》2020年第3期25-26,共2页Chinese Community Doctors

摘　　要：目的:探讨无痕腹腔镜胆总管取石、Ⅰ期缝合及保胆取石技术的可行性和安全性。方法:2019年4-8月收治胆囊结石并胆总管结石患者20例,使用德国吉米2.9 mm超微创腹腔镜设备,采用三孔法,胆道镜放入胆囊和胆总管取石取出过程及判断经脐部孔完成,缝合胆囊、胆总管Ⅰ期缝合操作经第二、三孔完成。结果:全组手术均顺利,手术时间为2.45~4.12 h,平均3.05 h,术中出血量为45~150 mL,平均75 mL;术中术后无并发症;住院时间为3~7 d,平均5.10 d出院;随访时间为1~4个月,平均2.8个月;腹壁瘢痕不明显。结论:采用德国吉米2.9 mm腹腔镜设备,能顺利完成胆总管取石、Ⅰ期缝合、保胆取石技术,患者术后切口疼痛更轻,康复更快,腹部无明显瘢痕,美容意义更优。Objective:To explore the feasibility and safety of traceless laparoscopy choledocholithotomy,primary closure and cholecystolithotomy with gallbladder preserved.Methods:20 patients with cholecystolithiasis and choledocholithiasis were selected from April to August 2019,using the German Jimmy 2.9 mm ultra-invasive laparoscopic device,using the three-hole method,the choledochoscope was placed into the gallbladder and the common bile duct to remove the stone and the umbilical hole was determined.The suture of the gallbladder,primary suture of common bile duct was completed through the second and third holes.Results:All patients underwent surgery smoothly.The operation time was 2.45~4.12 h,with an average of 3.05 h.The intraoperative blood loss was 45~150 mL with an average of 75 mL.There were no complications during the operation.The hospital stay was 3~7 days,and the average hospital discharge was 5.10 days.The follow-up time was 1 to 4 months,with an average of 2.8 months.No obvious scar on abdominal wall.Conclusion:The use of German Jimmy 2.9 mm laparoscopic equipment can successfully complete choledocholithotomy primary closure and cholecystolithotomy with gallbladder preserved.The patients'postoperative incision pain is lighter,the recovery is faster,the abdomen has no obvious scar,and the aesthetic significance is better.

关 键 词：无痕腹腔镜 胆总管取石 Ⅰ期缝合 保胆取石技术 

分 类 号：R657.42[医药卫生—外科学]