腹腔镜下经胆囊管取石治疗胆囊结石合并胆总管继发结石32例体会.docxVIP

腹腔镜下经胆囊管取石治疗胆囊结石合并胆总管继发结石32例体会 摘要：目的探讨腹腔镜下经胆囊管胆道镜取石 治疗胆囊结石合并胆总管继发微小结石的疗效及临床 价值。方法对2009年10月-2013年10月攀枝花市十 九冶医院肝胆胰外科32例胆囊结石合并胆总管继发 微小结石的患者，行腹腔镜胆囊切除术后经胆囊管胆 道镜取石治疗胆总管继发结石，观察其临床效果。结 果32例均顺利完成经胆囊管胆道镜取石，所有患者均 放置温氏孔引流管，未放置T管，术后2?4d拔除， 术后平均住院时间5d。术后对所有患者跟踪随访3月， 无漏胆、结石残余、胆道感染等并发症发生。结论腹 腔镜下经胆囊管胆道镜取石治疗胆囊结石合并胆总管 继发微小结石，避免了传统胆总管切开取石需放置T 管引流，具有创伤小、恢复快、安全等优点，是治疗 胆囊结石合并胆总管继发微小结石的理想术式，具有 较高的临床应用价值。 关键词：腹腔镜；胆总管继发结石；胆道镜；经 胆囊管取石 Laparoscopic Transcystic Duct Exploration in Treatment of Cholecystolithiasis with Common Bile Duct Stones Secondary to the Experience of 32 Cases LI Zheng-zong,ZHU Wan-xi,ZHU Ping (Department of Hepatobiliary and Pancreatic Surgery,Panzhihua City Nineteen Metallurgical Hospitalf anzhihua 617023,Sichuan,China) Abstract： ObjectiveTo investigate the laparoscopic via the cystic duct choledochoscope lithotomy treatment the curative effect of gallbladder stone with secondary small common bile duct calculi and its clinical value.Methodslin October 2009 to October 2013, mr.zhang 19 smelting hospital GanDanYi surgical 32 cases of gallbladder stone with secondary small common bile duct calculi patients, line after laparoscopic cholecystectomy via the cystic duct choledochoscope treat secondary bravery manager stone stone, observe its clinical effect.Results32 cases were successfully completed by the cystic duct biliary lithotomy lens, all patients were placed its hole drainage tube, not to place the T tube, out after 2 ?4 days, the average hospitalization time after 5 days? On all of the patients after 3 months follow-up, no residual bile leakage, calculi, biliary complications such as infection.ConclusionLaparoscopic cystic duct choledochoscope lithotomy treatment of gallbladder stone with secondary small common bile duct calculi, avoid the traditional cut take bravery manager stone need to put the T tube drainage, has the advantages of small trauma, rapid recovery, security, is the treatment of gallbladder stone with secondary small common bile duct calculi surgery,