腹腔镜与十二指肠镜治疗胆总管结石98例

目的探讨腹腔镜胆总管探查取石术与经十二指肠镜乳头切开取石术后再行腹腔镜胆囊切除术在治疗胆总管结石中的临床价值。方法选择98例胆囊结石并发胆总管结石的患者,16例行腹腔镜胆总管探查取石术,82例行经十二指肠镜乳头切开取石术后再行腹腔镜胆囊切除术。结果16例行腹腔镜胆总管探查取石术患者无1例出现并发症,82例经十二指肠镜乳头切开取石术后再行腹腔镜胆囊切除术患者,出现2例胰腺炎,1例可疑肠漏,3例因患者不能合作未能取石,其中有2例中转开腹手术。结论腹腔镜与十二指肠镜治疗胆总管结石均为微创手术,各有其优点,故术前应行全面检查,严格评估手术适应证,将患者住院时间、费用及合并症降至最低。

Laparoscope Common Bile Duct Exploration and Combined Usage of Laparoscope and Duodenoscope in the Treatment of Common Bile Duct Stone

Objective A retrospective review was undertaken to comparison the efficiency difference of laparoscope common bile duct exploration(LCBDE) and combined usage of laparoscope and duodenoscope in the treatment of common bile duct(CBC) stone.Methods 98 patients of CBC stone were treated totally during 2003 to 2005.16 of them were carried out LCBDE,82 patients were carried out endoscopic retrograde cholangiopancrealtography(ERCP) and endoscopic sphincterotomy(EST) first,then laparoscopic cholecystectomy(LC).Results LCBDE was successfully performed in all 16 cases,but 6 of 82 cases suffered complication in the combined usage of laparoscope and duodenoscope.Conclusion LCBDE combined usage of laparoscope and duodenoscope in the treatment of CBD are minimal traumatic operation with less complication.As the effective microhurt technique,the application of them will spread deservedly.