腹腔镜联合胆道镜治疗胆总管结石.pdfVIP

·635· ·论著· 腹腔镜联合胆道镜治疗胆总管结石 徐权斌叶永强 【摘要】 目的 探讨腹腔镜治疗胆总管结石的合适方法。方法 回顾性分析我院2005年5月 至2009年7月135例腹腔镜胆总管结石患者临床资料。结果全组均治愈康复，102例手术成功， 33例中转开腹手术。102例成功手术患者中，三孔法完成手术13例．四孔法完成手术89例，其中直 接经胆总管前壁96例，经胆囊管途径6例。胆总管一期缝合33例，放置“T”管引流63例。其中3例 出现一过性胆漏，3～5d后自愈，2例术后有结石残留，后经“T”管窦道胆道镜成功取出。结论腹腔 镜胆总管结石治疗应遵循个体化方案．根据患者病情、医院技术力量、条件不同，采取合适的治疗方 式。 【关键词】腹腔镜术； 胆总管结石； 胆道镜 Tr明tmentwith and fchoIed毗lolithi躯虹XUQ“口竹一6in，YE Iapar峭c叩ycholedocho鸵0py y0以g-q妇ng． shnnzian274300，P．R．Chi触 DepnrtmentofHep4￡obilinrysllrgery，ShQ挖zianC跏trnzHospilalt 63．fo，咒 (brrPs户D”di打gⅡ“￡，lor：XUIQl‘口竹一6i咒，E，，h口if：zHq￡m力6in01@1 【Abstnct】 Todeterminethemost methodinthetreatmentofcholedo- objective appmpriate cholithiasis．I订ethodsTheclinicaldataof135 whoreceivedeither commonbile patients laparoscopic duct commonbileduct exploration(LCBDE)orlaparoscopictranscystic expIoration(TC—BDE)from 2005to 2009were studied．ResultsAll werecuredofcholedocholi- May July retrospectively patients thiasis．In13 threetroc8rswereused，in89 fourtrocarswereused，andin33 patients patients pa— tientsconversionto wasdone．ofthe102 inwhomminimalinvasive openoperation patients sur苫ery was carriedout，TC—BDEwasdonein6 andLCBDEin96 cIo— successfulIy patients patients．Primary sureofcommonbileduct(CBD)wascarriedoutin33 whi王e’r-tube wasdonein patients drainage 63 Six hadatransientbileIeakwhichhealed in3 to4 Retained patients．patients spontaneouslydays． stonewasdetectedin2 whichwas retrieved patients successfullythroughchole