CAJ | 학술논문

目的探讨腹腔镜下治疗胆囊管结石的效果.方法回顾性分析76例胆囊管结石患者的临床资料和手术过程.结果 76例患者中62例成功实施腹腔镜胆囊切除术.术中出血量15~150 ml, 平均术中出血量55 ml.术后出现胆汁渗漏2例, 1例为胆囊床渗漏, 72 h拔管, 1例胆漏持续4周, 4周后造影未见胆道系统显影, 拔除引流管治愈.其余患者术后无严重并发症及死亡.术后随访12 个月, 未发现胆管狭窄及残余结石.结论腹腔镜处理胆囊管结石是安全可行的.胆囊切除中谨慎处理胆囊管防止结石遗漏, 灵活运用腹腔镜技术是手术成功的关键, 值得临床推广应用.
목적 탐토복강경하치료담낭관결석적효과.방법 회고성분석76례담낭관결석환자적림상자료화수술과정.결과 76례환자중62례성공실시복강경담낭절제술.술중출혈량15~150 ml, 평균술중출혈량55 ml.술후출현담즙삼루2례, 1례위담낭상삼루, 72 h발관, 1례담루지속4주, 4주후조영미견담도계통현영, 발제인류관치유.기여환자술후무엄중병발증급사망.술후수방12 개월, 미발현담관협착급잔여결석.결론 복강경처리담낭관결석시안전가행적.담낭절제중근신처리담낭관방지결석유루, 령활운용복강경기술시수술성공적관건, 치득림상추엄응용.
Objective To investigate effect of laparoscopic treatment for cystic duct calculi.Methods Clinical data of surgical process of 76 patients with cystic duct calculi were retrospectively analyzed. Results All the 62 cases among 76 patients received successful LC. Their intraoperative bleeding volume was 15~150 ml, with the average volume as 55 ml. There were 2 cases with postoperative bile leakage, and 1 case with gallbladder bed leak. They received extubation in 72 h, and 1 case had bile leakage for 4 weeks. Radiography after 4 weeks showed no biliary imaging in this case, which was cured after extubation of drainage tube. There were no severe adverse reactions or death in the other cases. Follow-up lasted for 12 months after operation, and that showed no bile duct stricture or retained calculi.Conclusion Laparoscope is feasible and safe in treatment of cystic duct calculi. Detailed management of cystic duct to prevent calculi leakage and flexible implement of laparoscope are the keys to successful operation. This method is worthy of clinical promotion and application.