CAJ | 학술논문

目的探讨改进腹腔镜下治疗胆囊结石合并胆管结石的手术方式,以期提高腹腔镜治疗胆囊结石合并胆管结石的成功率.方法对60例胆囊结石合并胆管结石的患者,行腹腔镜胆囊切除及经胆囊管开口微切开胆管探查取石并一期缝合胆管(简称LcTDE)术.结果全组60例,均成功采用LcTDE.胆管内取出单一结石32例,2～6枚结石28例.手术时间(38.7±15.1)min,住院时间(5.5±2.1)d.术后出现胆瘘1例,引流7d后无胆汁渗漏,拔除引流管,痊愈出院.术后1个月发现胆管残留结石1例,经内镜逆行胆胰管造影取出结石,痊愈.其余病例无胆管狭窄、胆管残留结石及其他手术并发症发生.结论 LcTDE术具有手术时间短、术式简单易行、术后胆漏少且易控制的特点,是胆囊合并胆管结石很好的微创治疗方法.
목적 탐토개진복강경하치료담낭결석합병담관결석적수술방식,이기제고복강경치료담낭결석합병담관결석적성공솔.방법 대60례담낭결석합병담관결석적환자,행복강경담낭절제급경담낭관개구미절개담관탐사취석병일기봉합담관(간칭LcTDE)술.결과 전조60례,균성공채용LcTDE.담관내취출단일결석32례,2～6매결석28례.수술시간(38.7±15.1)min,주원시간(5.5±2.1)d.술후출현담루1례,인류7d후무담즙삼루,발제인류관,전유출원.술후1개월발현담관잔류결석1례,경내경역행담이관조영취출결석,전유.기여병례무담관협착、담관잔류결석급기타수술병발증발생.결론 LcTDE술구유수술시간단、술식간단역행、술후담루소차역공제적특점,시담낭합병담관결석흔호적미창치료방법.
Objective To study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.