CAJ | 학술논문

目的探讨运用腹腔镜纤维胆道镜联合对肝外胆管结石进行切开探查取石及一期缝合的临床价值和治疗经验. 方法回顾性分析增城市人民医院以及广东医学院附属医院2012年1月至2014年1月选择性运用腹腔镜联合胆道镜探查取石一期缝合治疗肝外胆管结石29例.结果 29例手术均获成功,无中转开腹;手术时间55~165 min,平均(95±22) min.术中出血5~45 ml,平均(20±11) ml.术后1~2 d拔除引流管,全部治愈出院,术后平均住院时间为(7.5±0.7) d.术后随访复查6~12个月,无残余结石﹑胆瘘及其他严重并发症. 结论严格选择性运用腹腔镜联合胆道镜探查取石一期缝合切实可行﹑安全﹑可靠,有条件的医疗单位可对适宜的病例选择性地进行推广应用.
목적 탐토운용복강경섬유담도경연합대간외담관결석진행절개탐사취석급일기봉합적림상개치화치료경험. 방법 회고성분석증성시인민의원이급엄동의학원부속의원2012년1월지2014년1월선택성운용복강경연합담도경탐사취석일기봉합치료간외담관결석29례.결과 29례수술균획성공,무중전개복;수술시간55~165 min,평균(95±22) min.술중출혈5~45 ml,평균(20±11) ml.술후1~2 d발제인류관,전부치유출원,술후평균주원시간위(7.5±0.7) d.술후수방복사6~12개월,무잔여결석﹑담루급기타엄중병발증. 결론 엄격선택성운용복강경연합담도경탐사취석일기봉합절실가행﹑안전﹑가고,유조건적의료단위가대괄의적병례선택성지진행추엄응용.
Objective To summarize the experience of laparoscopy combined with fibrocholedo-choscopy for the treatment of calculus of extrahepatic bile duct. Methods Twenty-nine patients who under-went calculus of extrahepatic bile duct were studied from January 2012 to January 2014 in Zengcheng Peo-ple's Hospital and the Affiliated Hospital of Guangdong Medical College. Laparoscopic common bile duct ex-ploration (LCBDE) and choledochoscopy with primary closure were performed in those patients. Results There was no mortality and bile duct injury. None of them was converted to open surgery. Operation time ranged from 55 to 165 min, with an average of (95±22) min. Blood loss was 5 to 45 ml, with a mean of (20±11) ml. Tubes were removed 1 to 2 days postoperatively, and mean hospital stay was (7.5±0.7) d. A 6-to 12-month follow-up found no postoperative complications, such as biliary fistula and residual stone. Conclusion Laparoscopic primary closure of calculus of extrahepatic bile duct is safe and effective for the management of calculus of extrahepatic bile duct, and can be performed selectively in qualified hospitals.