中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
17期
19-21
,共3页
高洪军%刘辉%叶小汉%理建华
高洪軍%劉輝%葉小漢%理建華
고홍군%류휘%협소한%리건화
腹腔镜%纤维胆道镜%肝内外胆管结石
腹腔鏡%纖維膽道鏡%肝內外膽管結石
복강경%섬유담도경%간내외담관결석
Laparoscopy%Choledochoscopy%Intrahepatic and extrahepatic bile duct stones
目的 探讨腹腔镜联合胆道镜治疗肝内外胆道结石的方法及临床效果.方法 回顾性分析漯河市第六人民医院微创外科2006年9月至2012年7月运用腹腔镜联合胆道镜技术治疗的93例肝内外胆道结石患者的临床资料.结果 93例患者中91例行胆囊切除、胆总管切开取石、胆道镜探查术,其中81例术后行T管引流,10例行胆总管一期缝合.2例行胆囊切除后经胆囊管探查取石术.手术时间100 ～ 190 min,术中出血30 ～ 60 ml,平均住院时间7d,术后2例出现胆漏,2例出现主操作孔感染,无胆道损伤、大出血、结石残留等并发症,所有患者均治愈出院.结论 腹腔镜联合胆道镜治疗肝内外胆道结石是一安全可行、有效的理想手术方式,具有创伤小、痛苦轻、恢复快、住院时间短等微创优势,胆道镜的应用能更好地避免结石残留.
目的 探討腹腔鏡聯閤膽道鏡治療肝內外膽道結石的方法及臨床效果.方法 迴顧性分析漯河市第六人民醫院微創外科2006年9月至2012年7月運用腹腔鏡聯閤膽道鏡技術治療的93例肝內外膽道結石患者的臨床資料.結果 93例患者中91例行膽囊切除、膽總管切開取石、膽道鏡探查術,其中81例術後行T管引流,10例行膽總管一期縫閤.2例行膽囊切除後經膽囊管探查取石術.手術時間100 ～ 190 min,術中齣血30 ～ 60 ml,平均住院時間7d,術後2例齣現膽漏,2例齣現主操作孔感染,無膽道損傷、大齣血、結石殘留等併髮癥,所有患者均治愈齣院.結論 腹腔鏡聯閤膽道鏡治療肝內外膽道結石是一安全可行、有效的理想手術方式,具有創傷小、痛苦輕、恢複快、住院時間短等微創優勢,膽道鏡的應用能更好地避免結石殘留.
목적 탐토복강경연합담도경치료간내외담도결석적방법급림상효과.방법 회고성분석탑하시제륙인민의원미창외과2006년9월지2012년7월운용복강경연합담도경기술치료적93례간내외담도결석환자적림상자료.결과 93례환자중91례행담낭절제、담총관절개취석、담도경탐사술,기중81례술후행T관인류,10례행담총관일기봉합.2례행담낭절제후경담낭관탐사취석술.수술시간100 ～ 190 min,술중출혈30 ～ 60 ml,평균주원시간7d,술후2례출현담루,2례출현주조작공감염,무담도손상、대출혈、결석잔류등병발증,소유환자균치유출원.결론 복강경연합담도경치료간내외담도결석시일안전가행、유효적이상수술방식,구유창상소、통고경、회복쾌、주원시간단등미창우세,담도경적응용능경호지피면결석잔류.
Objective To investigate the application and the clinical effect of laparoscopy combined with choledochoscopy in the treatment of calculus of intrahepatic or extrahepatic duct.Methods The clinical data of 93 cases of biliary calculi,which were treated by the application of laparoscope combined with choledochoscope techniques from September 2006 to July 2012 in our department were retrospectively analyzed.Results Among the 93 cases:91 cases were treated by gallbladder removal,choledocholithotomy and choledochoscope exploration; 81 cases were treated with T-tube drainage after operation,and 10 cases were treated with choledochus primary suture.Two cases underwent biliary duct exploration transcystic duct after cholecystectomy.The time of operation wasl00 to 190 minutes.The amount of intraoperative bleeding was 30 ml to 60 ml.The average hospital stays was 7 days.There were 2 cases with bile leakage after operation and 2 cases with the main operation hole infection.All of the patients were healed without the complication such as bile duct injury,massive haemorrhage,calculi residual.Conclusions Laparoscopy combined with choledochoscopy is a safe,accessible and effective surgery method to treat intrahepatic and extrahepatic bile duct stones.Laparoscopy combined with choledochoscopy surgery has advantages of little damage,less pain,quick recovery and short time in hospital.The application of choledochoscopy is more effective to avoid calculi residual.
