CAJ | 학술논문

目的探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的合适方法.方法回顾性分析2007年10月~2012年4月188例腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石患者的临床资料.结果所有患者均成功腹腔镜切除胆囊,胆道镜取石169例成功,19例中转开腹.169例成功手术中,经胆囊管途径33例,经胆总管途径136例,胆总管一期缝合47例,13例出现胆瘘保持引流通畅3~6d后自愈.放置T管引流89例,其中85例T管造影未发现结石,顺利拔出T管,4例手术T管造影有结石残留,后经T管窦道胆道镜取出.结论腹腔镜联合胆道镜是治疗胆囊结石合并胆道结石的理想手术方式,但需根据患者病情采取合适的治疗方式.
목적탐토복강경연합담도경치료담낭결석합병담총관결석적합괄방법.방법회고성분석2007년10월~2012년4월188례복강경연합담도경치료담낭결석합병담총관결석환자적림상자료.결과소유환자균성공복강경절제담낭,담도경취석169례성공,19례중전개복.169례성공수술중,경담낭관도경33례,경담총관도경136례,담총관일기봉합47례,13례출현담루보지인류통창3~6d후자유.방치T관인류89례,기중85례T관조영미발현결석,순리발출T관,4례수술T관조영유결석잔류,후경T관두도담도경취출.결론복강경연합담도경시치료담낭결석합병담도결석적이상수술방식,단수근거환자병정채취합괄적치료방식.
Objective To investigate the most appropriate method in the treatment of common bile duct and gallbladder stone.Methods The clinical data of 188 patients undergoing laparoscopic common bile duct and gallbladder stone from October 2007 to April 2012 were analyzed retrospectively.Results All cases were successful laparoscopic resection in patients with gallbladder.Choledochoscope stone-free 169 cases were successful and 19 patients conversion to open operation was done.Of the 169 patients in whom minimal invasive surgery was successfully carried out,laparoscopic transcystic common bile duct exploration(TCBDE) was done in 33 patients and laparoscopic common bile duct exploration(LCBDE) in 136 patients.Primary closure of common bile duct(CBD) was carried in 47 patients,3 patients had a transient bile leak which healed spontaneously in 3 to 6 days.T-tube drainage was done in 89 patients.Retained stone was detected in 4 patients which was successfully retrieved through choledochoscopy.Conclusion Laparoscopic combined with choledochoscopy is an ideal operation method in treating common bile duct and gallbladder stone,but the choice of the procedure depends on the number,size of stons and the patient’s choice.