腹腔镜胆囊型保留Oddi括约肌的胆管整形皮下盲襻埋置术的中期随访结果

发布时间：2018-05-21 03:35

本文选题：肝内胆管结石病 + 腹腔镜　；参考：《中国微创外科杂志》2017年12期

【摘要】：目的探讨腹腔镜胆囊型保留Oddi括约肌的胆管整形皮下盲襻埋置术(Oddi sphincter-preserved cholangioplasty with hepatico-subcutaneous stoma,OSPCHS)微创治疗肝内胆管结石病的疗效。方法 2011年1月~2016年5月我院采用完全腹腔镜胆囊型OSPCHS治疗肝内胆管结石17例,在保留Oddi括约肌的前提下,打开肝门部胆管,形成盆状,胆囊修复胆管前壁,胆囊底部埋置皮下,同时联合行病变肝脏切除术。结果结石清除率82.4%(14/17)。17例术后平均随访38.5月(11~67个月):胆管炎发作1例,复发率5.9%(1/17);3例结石复发(21.4%,3/14),采用小切口盲襻切开、胆道镜取石。结论腹腔镜胆囊型OSPCHS治疗肝内胆管结石病可获得满意的中期疗效。
[Abstract]:Objective to investigate the effect of laparoscopic cholecystectomy with Oddi sphincter retained in the treatment of intrahepatic bile duct lithiasis by subcutaneous blind loop implantation of Oddi sphincter-preserved cholangioplasty with hepatico-subcutaneous stoma OS-PC HS.Methods Laparoscopic cholecystic sphincter was used to treat intrahepatic cholangiolithiasis. Methods from January 2011 to May 2016, 17 cases of intrahepatic cholelithiasis were treated with laparoscopic cholecystolithiasis (OSPCHS). On the premise of preserving the sphincter of Oddi, the hilar bile duct was opened to form the pelvic shape and the gallbladder repaired the anterior wall of the bile duct. The bottom of the gallbladder was buried subcutaneously and combined with hepatectomy. Results the stone clearance rate was 82.4% / 17%. 17 cases were followed up for an average of 38.5 months for 11 ~ 67 months: 1 case had a cholangitis attack, and the recurrence rate was 5.9% / 17%. The stone recurrence rate was 21.4% / 14%. Small incision blind loop incision and choledochoscopy were used to remove the stone. Conclusion Laparoscopic cholecystolithiasis OSPCHS is a good medium-term treatment for intrahepatic cholangiolithiasis.
【作者单位】：北京大学第三医院普外科;
【基金】：北京市自然科学基金(7172233)
【分类号】：R657.42

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