腹腔镜下经胆囊管胆道镜胆总管探查取石手术的方法及疗效初步的研究.docVIP

腹腔镜下经胆囊管胆道镜胆总管探查取石手术的方法及疗效初步的研究 　　[摘要] 目的 分析腹腔镜下经胆囊管胆道镜胆总管探查取石手术方法及疗效。方法 整群选取回顾性分析该院2013年1月―2014年12月之间收治的68例腹腔镜下经胆囊管胆道镜胆总管探查取石手术治疗患者的临床资料，分析该术式治疗结石的方法与效果。结果 通过探查，该组68例患者胆总管无异常的有31例、胆总管下段结石患者6例，呈现松软泥沙样。手术过程中进行冲洗，并使用胆道镜推入十二指肠中。患者的住院时间在3～10 d之间，通过6个月的随访未见复发现象。结论 手术前加强筛查，严格掌握禁忌症的情况下行腹腔镜下经胆囊管胆道镜胆总管探查取石手术治疗胆总管结石具有较高的可行性与安全性。 　　[关键词] 腹腔镜；经胆囊管胆道镜胆总管探查取石手术；临床效果 　　[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-0742（2016）05（b）-0108-03 　　[Abstract] Objective To analyze the operation method and curative effect of laparoscopic common bile duct exploration and lithotomy through cystic duct under choledochoscope. Methods The clinical data of 68 cases of patients with laparoscopic common bile duct exploration and lithotomy through cystic duct under choledochoscope operation admitted and treated in our hospital from January 2013 to December 2014 were retrospectively analyzed， and the method and effect of the operation in treatment of stones were analyzed. Results Of 68 cases of patients after exploration， the common bile duct of 31 cases was without abnormalities， 6 cases were with stones of lower commonbile duct segment， presenting soft sand-like shapes， and the stones were washed in operation and pushed into the duodenum by choledochoscope， and the length of stay of patients was between 3 d and 10 d， and the recurrence did not occur after 6-month follow-up. Conclusion Laparoscopic common bile duct exploration and lithotomy through cystic duct under choledochoscope in treatment of choledocholithiasis has higher feasibility and safety if we enhance screening and strictly master the contraindication before operation. 　　[Key words] Laparoscope； Laparoscopic common bile duct exploration and lithotomy through cystic duct under choledochoscope operation； Clinical effect 　　随着微创技术的发展，腹腔镜取石术在结石的治疗中得到了非常广泛的应用，在胆总管结石的治疗中，应用腹腔镜技术治疗需要掌握严格的手术禁忌症与适应症，在此基础上开展手术能够获得较好的成效[1-2]。该文对该院2013年1月―2014年12月之间收治的68例行经胆囊管胆道镜胆总管探查取石手术治疗患者的资料进行分析，探讨治疗方法与成效，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　整群选取并回顾性分析该院2013年1月―2014年12