中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
21期
115-116,117
,共3页
胆管总结石%腹腔镜联合胆道镜探查取石%一期缝合
膽管總結石%腹腔鏡聯閤膽道鏡探查取石%一期縫閤
담관총결석%복강경연합담도경탐사취석%일기봉합
Total bile duct stone%Laparoscopic choledochotomy%Primary suture
目的:探讨腹腔镜联合胆道镜行胆总管切开探查取石一期缝合的安全性与有效性。方法:回顾性总结分析周口市中医院普外科2009年1月-2012年1月间,经腹腔镜联合胆道镜行胆囊切除、胆总管切开取石一期缝合术,治疗胆囊结石合并胆总管结石57例患者的临床资料。结果:腹腔镜下联合胆道镜胆总管切开探查取石一期缝合成功52例,2例高龄患者术后因低蛋白血症出现胆漏,经抗感染、营养支持治疗10 d后治愈,治愈成功率91.2%。5例患者因胆总管解剖变异、扭曲、纤细直径<7 mm,结石>15 mm嵌顿取出困难,胆道出血、胆总管末端炎性水肿等原因而中转开腹并置入T管。全组手术时间90~160 min,平均(110±30)min。住院时间6~15 d,平均(10±3.3)d。1~3年随访51例,失访6例,随访率89.4%。随访的51例患者中,无胆总管狭窄及结石残留的发生。结论:腹腔镜联合胆道镜行胆总管切开探查取石一期缝合安全有效。
目的:探討腹腔鏡聯閤膽道鏡行膽總管切開探查取石一期縫閤的安全性與有效性。方法:迴顧性總結分析週口市中醫院普外科2009年1月-2012年1月間,經腹腔鏡聯閤膽道鏡行膽囊切除、膽總管切開取石一期縫閤術,治療膽囊結石閤併膽總管結石57例患者的臨床資料。結果:腹腔鏡下聯閤膽道鏡膽總管切開探查取石一期縫閤成功52例,2例高齡患者術後因低蛋白血癥齣現膽漏,經抗感染、營養支持治療10 d後治愈,治愈成功率91.2%。5例患者因膽總管解剖變異、扭麯、纖細直徑<7 mm,結石>15 mm嵌頓取齣睏難,膽道齣血、膽總管末耑炎性水腫等原因而中轉開腹併置入T管。全組手術時間90~160 min,平均(110±30)min。住院時間6~15 d,平均(10±3.3)d。1~3年隨訪51例,失訪6例,隨訪率89.4%。隨訪的51例患者中,無膽總管狹窄及結石殘留的髮生。結論:腹腔鏡聯閤膽道鏡行膽總管切開探查取石一期縫閤安全有效。
목적:탐토복강경연합담도경행담총관절개탐사취석일기봉합적안전성여유효성。방법:회고성총결분석주구시중의원보외과2009년1월-2012년1월간,경복강경연합담도경행담낭절제、담총관절개취석일기봉합술,치료담낭결석합병담총관결석57례환자적림상자료。결과:복강경하연합담도경담총관절개탐사취석일기봉합성공52례,2례고령환자술후인저단백혈증출현담루,경항감염、영양지지치료10 d후치유,치유성공솔91.2%。5례환자인담총관해부변이、뉴곡、섬세직경<7 mm,결석>15 mm감돈취출곤난,담도출혈、담총관말단염성수종등원인이중전개복병치입T관。전조수술시간90~160 min,평균(110±30)min。주원시간6~15 d,평균(10±3.3)d。1~3년수방51례,실방6례,수방솔89.4%。수방적51례환자중,무담총관협착급결석잔류적발생。결론:복강경연합담도경행담총관절개탐사취석일기봉합안전유효。
Objective:To study the effects of laparoscope combined with choledochoscope in common bile duct exploration and stone of the safety and effectiveness of suture.Method:A retrospective analysis from 2009 January to 2012 Department of general surgery in Zhoukou Hospital of Traditional Chinese Medicine in January after the laparoscopic cholecystectomy,choledocholithotomy and primary suture,clinical data of the treatment of cholecystolithiasis and choledocholithiasis in 57 patients.Result:All patients who received laparoscopy combined with choledochoscopy in the exploration of common bile duct stone suture was successful in 52 cases,2 elderly patients with hypoproteinemia bile leakage,the anti-inflammatory,nutritional support for patients with 10 d after cure,the cure rate of success was 91.2%.5 patients with common bile duct anatomic variation,twisted,slender diameter<7 mm,Stone>15 mm inlaid the removal difficulties,at the end of common bile duct biliary tract hemorrhage,inflammatory edema and other reasons and laparotomy and put into T tube.Operation time was 90-160 min,average( 110 ±30 )min. The average hospitalization time was 6-15 d, average(10±3.3)d.1-3 years follow-up of 51 cases,6 cases lost follow-up,follow-up rate was 89.4%. 51 cases with follow-up,no residual bile duct stricture and stone.Conclusion:The laparoscopic common bile duct exploration stone is a safe and effective suture.