残余胆囊结石经腹腔镜残余胆囊切除治疗体会  

Experience of laparoscopic resection of residual gallbladder for residual cholecystolithiasis

作　　者：季月辉 邱钧 李志贵 JI Yue-hui;QIU Jun;LI Zhi-gui(Department of Hepatobiliary Surgery,Wuhu First People’s Hospital,Wuhu,Anhui 241000,China)

机构地区：[1]芜湖市第一人民医院肝胆外科,安徽芜湖241000

出　　处：《肝胆胰外科杂志》2021年第11期677-679,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨残余胆囊结石行腹腔镜手术的可行性。方法回顾性分析芜湖市第一人民医院肝胆外科2017年12月至2020年12月收治的17例LC术后残余胆囊结石病例资料,总结患者术前、术中和术后情况。结果14例残余胆囊结石患者行腹腔镜手术下残余胆囊切除术,3例合并胆总管结石的患者行腹腔镜下残余胆囊切除+胆总管切开取石+T管引流术。整体手术时间(105.9±23.1)min,术中出血量(21.8±11.0)mL,术后腹腔引流管拔除时间(4.9±1.5)d,术后住院时间(9.3±1.7)d。2例患者术后出现低热,转氨酶及胆红素升高,对症支持治疗后明显好转。所有患者均恢复良好,顺利出院。随访1年,均无明显症状,恢复良好。结论腹腔镜手术治疗残余胆囊结石是安全、可行的,对于残余胆囊结石合并胆总管结石可联合内镜和胆道镜治疗。Objective To investigate the feasibility of laparoscopic surgery for residual gallbladder stones.Methods Clinical data of 17 cases of residual gallbladder stones after LC in the Department of Hepatobiliary Surgery of Wuhu First People’s Hospital from Dec.2017 to Dec.2020 were analyzed retrospectively.The preoperative,intraoperative,postoperative and prognosis were summarized.Results Fourteen patients with residual gallstones underwent laparoscopic residual cholecystectomy,Three patients with choledocholithiasis underwent laparoscopic residual cholecystectomy+choledocholithotomy+T-tube drainage.The overall operation time was(105.9±23.1)min,the amount of intraoperative bleeding was(21.8±11.0)mL,the extraction time of abdominal drainage tube was(4.9±1.5)d,and the postoperative hospitalization was(9.3±1.7)d.Two patients had low fever,elevated transaminase and bilirubin,but improved significantly after symptomatic support treatment.All patients recovered well and discharged smoothly.Followed up for 1 year,there were no obvious symptoms and recovered well.Conclusion Laparoscopic surgery for residual gallstone is safe and feasible.For residual gallbladder combined with choledocholithiasis,endoscopy and choledochoscopy can be combined.

关 键 词：腹腔镜胆囊切除术 残余胆囊结石 胆总管结石 内镜下乳头括约肌切口术 

分 类 号：R657.4[医药卫生—外科学]