CAJ | 학술논문

目的探讨腹腔镜下球囊导管扩张内涵管引流术治疗复发性胆总管结石和胆管狭窄的适应证及临床效果.方法对我院1999年8月至2009年8月采用腹腔镜胆总管探查术(LCBDE)、腹腔镜球囊导管扩张内涵管引流(LPBD LPBDC)治疗的61例胆道术后胆总管复发结石临床资料进行回顾性分析.结果 61例手术均获成功.其中20例球囊导管扩张后Ⅰ期缝合胆总管探查切口,36例借助内涵管支撑引流后Ⅰ期缝合胆总管探查切口,5例胆总管内放置T管引流.术后无胆漏及残石等并发症,无死亡病例.术后随访1～9.5年,平均5.5年,结石无一复发.结论腹腔镜下球囊导管扩张内涵管引流术治疗复发性胆总管结石和胆总管狭窄可以有效预防结石复发,安全、可行,体现了微创治疗的优点.
목적 탐토복강경하구낭도관확장내함관인류술치료복발성담총관결석화담관협착적괄응증급림상효과.방법 대아원1999년8월지2009년8월채용복강경담총관탐사술(LCBDE)、복강경구낭도관확장내함관인류(LPBD LPBDC)치료적61례담도술후담총관복발결석림상자료진행회고성분석.결과 61례수술균획성공.기중20례구낭도관확장후Ⅰ기봉합담총관탐사절구,36례차조내함관지탱인류후Ⅰ기봉합담총관탐사절구,5례담총관내방치T관인류.술후무담루급잔석등병발증,무사망병례.술후수방1～9.5년,평균5.5년,결석무일복발.결론 복강경하구낭도관확장내함관인류술치료복발성담총관결석화담총관협착가이유효예방결석복발,안전、가행,체현료미창치료적우점.
Objective To explore the effect of laparoscopic bile duct exploration,balloon dilation,and catheter drainage in the treatment of postoperative recurrent choledocholithiasis.Method The data of 61 patients with postoperative recurrent bile duct stones from August 1999 to August 2009 were retrospectively analyzed.The patients received laparoscopic bile duct exploration (LCDE),laparoscopic papillary balloon dilation (LPBD),and laparoscopic papillary balloon dilation endoprosthesis (LPBDE).Result Satisfactory outcome was achieved in all the 61 patients.Among the 61 patients,20 patients received LPBD and primary suturing,36 patients received LPBDE and primary suturing,and 5 patients received LPBDE and T-tube drainage.There was no residual stone.There was no perioperative mortality or serious complications including biliary leak and hemobilia.On follow up for 1 to 9.5 years in 56 patients,there was no recurrent choledocholithiasis.Conclusion The procedures were feasible and safe,and they prevent recurrence of choledocholithiasis.