改良腹腔镜胆总管探查术42例报告  

Modified laparoscopic exploration of common bile duct:A report of 42 cases

作　　者：徐德银[1] 吴振宇[1] 陆春明[1] 王荣[1] 薛彦俊[1] 葛玲[1] 

机构地区：[1]武警江苏总队医院外二科,扬州225003

出　　处：《中国微创外科杂志》2004年第3期195-196,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨腹腔镜胆总管探查取石T管引流的手术方法及器械的改进。　方法　 1996年 6月～ 2 0 0 3年 6月我院对 4 2例胆囊结石合并胆总管结石行腹腔镜手术时先不切胆囊 ,先显露胆总管 ,自制胆管切开刀切开胆总管。开腹器械镜下取石 ,纤维胆道镜检查 ,T管引流。　结果　 4 2例手术均获成功 ,无中转开腹。手术时间 (不包括LC手术时间 ) 80～ 180min ,平均 96min。术后 2 4h下床活动并进流食。术后住院 5～ 9d ,平均 6d。术后 3周胆道造影无异常拔除T管。无胆道残留结石及胆总管狭窄等并发症发生。 38例随访 6～ 4 8个月 ,平均 2 3个月 ,无结石复发及胆系症状。　结论　改良腹腔镜胆总管切开探查取石T管引流术治疗胆总管结石安全有效 ,改进的手术方法和器械可缩短手术时间。Objective To investigate the technique and instrument improvement of laparoscopic choledocholithotomy with T-tube drainage. Methods A total of 42 cases of gall stones complicated with common bile duct stones entered the study. During the operation, we exposed the common bile duct before the removal of the gall bladder, opened the common bile duct by a self-made bile duct scalpel, removed the stones by open instruments laparoscopically, and performed choledochofiberscopic examinations and T-tube drainages. Results All the 42 operations were successfully accomplished without the conversion to open surgery. The operation time (exclusive of that of LC) was 80～180 min (mean, 96 min). All the patients got out of bed and received liquids within 24 hours after the surgery. The postoperative hospital stay was 5～9 days (mean, 6 days). The T-tube was removed 3 weeks after the operation in the absence of residual stones or stenosis of bile duct under T-tube choledochography. Follow-up for 6～48 months (mean, 23 months) in 38 cases found no recurrence of stones or biliary tract symptoms. Conclusions The modified laparoscopic choledocholithotomy with T-tube drainage, which shortens the operation time, is an effective and safe method for the treatment of common bile duct stones.

关 键 词：腹腔镜 胆总管结石 T管引流 

分 类 号：R657.4[医药卫生—外科学]