【摘要】 目的 探讨腹腔镜联合胆道镜在治疗胆囊结石合并胆总管结石术中的应用和并发症的处理体会。方法 回顾性分析我院2004年2月至2011年1月期间221例腹腔镜下胆道镜胆总管探查取石术患者临床资料。结果 201例腹腔镜下完成手术，20例中转开腹。169例放置T管，术后10周158例经T管造影或超声检查，无残留结石后拔管；11例再次经T管瘘道行胆道镜取石，无胆漏出现。52例Ⅰ期胆总管缝合，术后4例再发胆总管结石，行EST治疗，术后胆漏2例，经保守治疗痊愈。平均住院时间9.5 d。结论 腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石是微创、安全、有效的治疗方式，T管的留置与否需重视。
【关键词】
腹腔镜；胆道镜；胆总管结石
Laparoscopic and choledochoscopic biliary tract surgery in the common bile duct incision
ZHANG Ziyang. The First General Surgery,The First People’s Hospital of Chaoyang City,Liaoning 122000,China
【Abstract】 Objective
To discuss the operative experience, common complications and preventions of the treatment of cholecystolithiasis combinatied with choledocholithiasis by laparoscope and choledochoscope. Methods Retrospective analysis 221 clinical records who was underwent the Laparoscopic and Choledochoscopic common bile duct exploration from Feb. 2004 to Jan.2011.Results 201 cases were successful underwent by Laparoscope, other 20 cases were transferred to laparotomy during laparoscopic procedure. T tubules were left in 169 cases, and 10 weeks later the drainage tube was removed after opacification or super sound.52 patients common bile ducts were sutured in PhaseⅠ. Calculus were obtained via the cystic duct in 11 cases. Postoperative bile leakage in 2 cases, expectant treated and cured. 4 cases of residual common bile duct stones, cured by EST. The average hospital stay was 9.5 d. Conclusion Laparoscopic and choledochoscopic biliary tract surgery in the common bile duct incision is of good efficacy, fewer complications and safe treatment, T tubules are important. ......
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【关键词】
腹腔镜；胆道镜；胆总管结石
Laparoscopic and choledochoscopic biliary tract surgery in the common bile duct incision
ZHANG Ziyang. The First General Surgery,The First People’s Hospital of Chaoyang City,Liaoning 122000,China
【Abstract】 Objective
To discuss the operative experience, common complications and preventions of the treatment of cholecystolithiasis combinatied with choledocholithiasis by laparoscope and choledochoscope. Methods Retrospective analysis 221 clinical records who was underwent the Laparoscopic and Choledochoscopic common bile duct exploration from Feb. 2004 to Jan.2011.Results 201 cases were successful underwent by Laparoscope, other 20 cases were transferred to laparotomy during laparoscopic procedure. T tubules were left in 169 cases, and 10 weeks later the drainage tube was removed after opacification or super sound.52 patients common bile ducts were sutured in PhaseⅠ. Calculus were obtained via the cystic duct in 11 cases. Postoperative bile leakage in 2 cases, expectant treated and cured. 4 cases of residual common bile duct stones, cured by EST. The average hospital stay was 9.5 d. Conclusion Laparoscopic and choledochoscopic biliary tract surgery in the common bile duct incision is of good efficacy, fewer complications and safe treatment, T tubules are important. ......
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