腹腔镜联合胆道镜经胆囊管汇入部微切开并一期缝合在胆总管探查取石术中的应用效果  

Application effect of laparoscope combined with choledochoscope for micro incision through the entrance of cystic duct and primary suture in common bile duct exploration and removing the stones

作　　者：王玉虎[1] 徐萌[1] 韩双喜[1] 高娜 WANG Yuhu;XU Meng;HAN Shangxi;GAO Na(Hepatobiliary Surgery Department,Binzhou Central Hospital,Binzhou 251700,China)

机构地区：[1]滨州市中心医院肝胆外科,山东滨州251700

出　　处：《临床医学研究与实践》2021年第16期61-63,共3页Clinical Research and Practice

基　　金：山东省医药卫生科技发展计划项目(No.2019WS010)。

摘　　要：目的总结腹腔镜联合胆道镜经胆囊管汇入部微切开并行一期缝合治疗胆总管结石的经验。方法回顾性分析2015年1月至2020年1月滨州市中心医院收治的65例采用腹腔镜联合胆道镜经胆囊管汇入部微切开行胆道探查取石术,并一期缝合切开处的胆总管结石患者的资料。结果65例均完成腹腔镜联合胆道镜经胆囊管汇入部微切开胆道探查取石术,取净结石并一期缝合胆囊管汇入部,未予留置T管。手术时间65~145 min,平均(85.3±25.7)min;术中出血量10~80 mL,平均(18.5±6.7)mL;术后住院时间3~8 d,平均(3.7±1.2)d;术后发生胆漏6例(9.2%),引流量15~200 mL,保留腹腔引流3~8 d后痊愈。术后结石复发2例,无胆总管狭窄病例。结论腹腔镜联合胆道镜经胆囊管汇入部微切开并一期缝合治疗胆总管结石,使取石难度降低,避免留置T管,安全有效。Objective To summarize the experience of laparoscope combined with choledochoscope for micro incision through the entrance of cystic duct and primary suture in the treatment of common bile duct stones.Methods From January 2015 to January 2020,the data of 65 patients with common bile duct stones admitted in Binzhou central hospital were retrospectively analyzed.The patients were treated with common bile duct exploration and removing the stones by laparoscope combined with choledochoscope for micro incision through the entrance of cystic duct and primary suture.Results All of the 65 patients completed the common bile duct exploration and removing the stones by laparoscope combined with choledochoscope for micro incision through the entrance of cystic duct.The stones were removed and the entrance of cystic duct was sutured at one stage,without T-tube indwelling.The operation time was 65-145 min,with an average of(85.3±25.7)min.The intraoperative blood loss was 10-80 mL,with an average of(18.5±6.7)mL.The postoperative hospital stay was 3-8 d,with an average of(3.7±1.2)d.Postoperative bile leakage occurred in 6 cases(9.2%)with drainage volume of 15-200 mL,and recovered after 3-8 d of retention of abdominal drainage.There were 2 cases of stone recurrence and no cases of common bile duct stenosis.Conclusion Laparoscope combined with choledochoscope for micro incision through the entrance of cystic duct and primary suture in the treatment of common bile duct stones can reduce the difficulty of removing stones and avoid T-tube indwelling,which is safe and effective.

关 键 词：腹腔镜 胆道镜 胆总管结石 胆总管探查术 一期缝合 

分 类 号：R65[医药卫生—外科学]