腹腔镜胆总管探查治疗胆囊切除术后复发或残留胆总管结石的临床疗效

发布时间：2017-12-31 01:35

本文关键词：腹腔镜胆总管探查治疗胆囊切除术后复发或残留胆总管结石的临床疗效　出处：《中国普通外科杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的:探讨腹腔镜下胆总管探查(LCBDE)治疗胆囊切除术后复发或残留胆总管结石的临床疗效。方法:回顾性分析2012年4月—2015年6月52例行LCBDE治疗的胆囊切除术后复发或残留胆总管结石患者临床资料。结果:52例患者中成功完成LCBDE 48例(92.3%),其余4例均因腹腔粘连致密而中转开腹手术。48例患者术中放置T管15例,行胆总管一期缝合33例;手术时间(102.6±19.5)min,术中出血量(38.6±12.7)m L,术后住院时间(4.2±2.5)d;术后发生轻微胆汁漏2例,拔T管后胆汁性腹膜炎1例,均经保守治疗痊愈;术后胆总管残留结石1例,于术后6周经T管窦道胆道镜下网篮取石治愈。结论:LCBDE治疗胆囊切除术后复发或残留胆总管结石成功率高,且微创、恢复快,推荐临床应用。
[Abstract]:Objective: To investigate the effect of laparoscopic common bile duct exploration (LCBDE) clinical curative effect of the treatment of post cholecystectomy residual or recurrent common bile duct stones. Methods: a retrospective analysis from April 2012 to June 2015 52 cases of LCBDE treated by cholecystectomy after recurrence or residual bile duct stones in patients with clinical data. Results: 52 patients successfully completed the LCBDE 48 cases (92.3%), the remaining 4 cases were due to dense adhesions and laparotomy.48 patients in 15 cases of T tube placement, a suture for bile duct in 33 cases; the operation time (102.6 + 19.5) min, the amount of bleeding (38.6 + 12.7) m L, postoperative hospitalization time (4.2. D; 2.5) had mild bile leakage in 2 cases, 1 cases of bile peritonitis after removal of T tube, were cured; 1 cases of biliary calculi after operation, 6 weeks after operation through T tube sinus endoscopic stone extraction cured. Conclusion: LCBDE treatment of gallbladder resection recurrent or residual bile The success rate of the common duct stone is high, and it is minimally invasive and fast. It is recommended for clinical application.

【作者单位】：苏州大学附属第三医院肝胆外科;
【基金】：常州市卫生计生委重大科技基金资助项目(ZD201502)
【分类号】：R657.4
【正文快照】： 胆囊切除术后残余或复发胆总管结石在临床石、胆道镜难以取净者。较为常见,由于已有右上腹手术史,过去视为腹1.2手术方法腔镜禁忌证。ERCP+EST曾一度成为胆囊切除术本组所有患者均行LCBDE,采用四孔法,首后复发胆总管结石的首选治疗方案,避免了再次先在脐上方切开1 cm,逐层切开

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