腹腔镜胆囊切除术后残余胆囊结石的外科处理

目的探讨腹腔镜胆囊切除术后残余胆囊结石的治疗和预防方法。方法回顾分析16例腹腔镜胆囊切除术后残余胆囊结石患者的诊治经过。结果结合彩超、MRCP、ERCP等检查方法均可确定诊断,通过开腹或腹腔镜下残余胆囊切除术,术后患者临床症状均有效缓解,无严重并发症。结论对于残余胆囊应该重视初次手术中的预防。腹腔镜下残余胆囊切除术安全可靠。当合并胆总管结石时,可联合内镜和腹腔镜分次治疗。术中胆道造影或胆道镜检查可增加手术安全。

Surgery managment of remnant gallbladder stone after laparoscopic cholecystectomy

Aim To explore treatment and prevention of remnant gallbladder stone after laparoscopic cholecystectomy（LC）.Methods A retrospective analysis was performed for the clinical data of 16 patients undergoing remnant gallbladder resection caused by LC. Results Ultrasound or MRI,ERCP can be used to diagnosis remnant gallbladder stone perfectly. All of the patients received remnant gallbladder resection with no serious complication and were cured. Conclusions To avoid the remnant gallbladder,more attention should be paid during LC. laparoscopic operation is feasible and safe for this diease. Endoscope can be used combined with laparoscope when complicated with secondary choledocholithiasis. The application of bile duct radiography or choledochoscope can make sure the security during the operation.