腹腔镜术中联合胆道镜治疗胆总管结石的临床疗效分析-东南大学学报医学版

腹腔镜术中联合胆道镜治疗胆总管结石的临床疗效分析

单位：南京医科大学第二附属医院普外科, 江苏南京 210011

分类号：R657.42;R616.5

出版年·卷·期（页码）：2018·37·第二期（248-251）

摘要：

目的：探讨腹腔镜联合胆道镜治疗胆总管结石的临床效果分析。方法：回顾性分析我院2013年1月至2016年12月收治62例胆总管结石患者行腹腔镜联合胆道镜胆总管切开取石治疗的临床及随访资料。结果：62例患者均腔镜下完成，平均手术时间145 min，术后平均住院时间6.7 d。胆瘘7例，均保守治疗治愈；肠管损伤5例，腔镜下完成修补。无胆管损伤、出血、肠瘘及胆道狭窄等严重并发症。术后2~3年复发胆总管结石5例，3例再次行腔镜手术，另2例合并肝内胆管结石，行开腹手术。结论：腹腔镜术中联合胆道镜治疗胆总管结石安全有效，较开腹手术有创伤小、恢复快等优点。

Objective:To investigate the clinical effect of laparoscopy combined with choledochoscopy for the treatment of common bile duct stones. Methods:The clinical data of 62 patients with choledocholithiasis who accepted the treatment of laparoscopic cholecystectomy combined with choledocholithotomy from January 2013 to December 2016 were retrospectively analyzed. Results:All of the 62 patients underwent operation by laparoscopy combined with choledochoscopy. The average operation time was 145 min, the average hospitalization days after operation were 6.7 d. No bile duct injury, bleeding, intestinal fistula and biliary stricture and other serious complications happened. The biliary fistula happened in 7 cases, which were cured by conservative treatment, intestinal injury in 5 cases which was repaired by laparoscopy. Recurrence of common bile duct stones 2 to 3 years after operation happened in 5 cases, 3 cases accepted reoperation by laparoscopy, the other 2 cases finished the therapy by open surgery due to complicated with intrahepatic bile duct stones. Conclusion:Laparoscopic surgery combined with choledochoscopy for the treatment of common bile duct stones is safe and effective with advantages of minimal invasion, quick recovery and fewer complications.

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