PDF下载 ( 1419 KB)
Clinical application of laparoscopy combined with choledochoscopy for treatment of gallstones with common bile duct stones in primary hospitals
-
摘要:
目的总结腹腔镜联合胆道镜微创手术治疗胆囊结石合并胆总管结石在基层医院的应用体会。方法分析2010年3月至2013年12月昆明医科大学第一附属医院46例腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石患者的临床资料。结果 46例患者均成功在双镜联合下完成手术,治愈出院,无中转开腹病例,平均手术(100.0±20.2)min,平均住院(7.0±1.4)d,手术平均失血(77±21)ml。其中腹腔镜下留置T管引流41例,胆总管Ⅰ期缝合3例,经胆囊管插入胆道镜取石2例。术后均无残余结石、无胆漏等严重并发症发生。结论腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石,具有微创、安全、恢复快、患者满意度高的优点,值得在基层医院推广应用,但须严格掌握适应证。
Abstract:Objective To summarize the clinical application of laparoscopy combined with choledochoscopy for treatment of gallstones with common bile duct stones in primary hospitals. Methods The clinical data of 46 patients who were diagnosed as having gallstones with common bile duct stones and underwent laparoscopy combined with choledochoscopy from March 2010 to December 2013 were analyzed. Results All 46 patients successfully completed the combined minimally invasive procedure, and none was converted to open surgery. The mean operating time was 100 ± 20. 2 min. The mean length of hospital stay was 7. 0 ± 1. 4 days. The mean intraoperative blood loss was 77 ± 21 ml.Forty- one cases had laparoscopic T- tube drainage. Three cases had primary suture of the common bile duct. Two cases had stone extraction by choledochoscopy. No severe postoperative complications such as residual stones and bile leakage were observed. Conclusion The minimally invasive procedure of laparoscopy combined with choledochoscopy for treatment of gallstones and common bile duct stones has multiple advantages, including low risk, fast recovery, and high patient satisfaction. This application could be adopted in primary hospitals.
-
Key words:
- laparoscopes /
- choledochoscope /
- cholecystolithiasis /
- choledocholithiasis /
- primary hospital
-
[1]XIAO XL, SU SY.Advances in endoscopic technique for diagnosis and treatment of bile duct stones[J].J Med Res, 2012, 41 (4) :178-181. (in Chinese) 肖修林, 苏树英.内镜技术在胆管结石的诊治进展[J].医学研究杂志, 2012, 41 (4) :178-181. [2]GONG JM, LU SC, FAN Y.Clinical analysis of laparoscope combined with choledochoscope surgery for choledocholithiasis[J].China Med Herald, 2013, 10 (21) :53-54. (in Chinese) 龚加明, 卢思聪, 范莹.腹腔镜联合胆道镜治疗总管结石临床分析[J].中国医药导报, 2013, 10 (21) :53-54. [3]LIU Y, YU G, DUAN SB.Observation on clinical carative effect of aparoscopy combined with choledochoscopy in the treatment of cholecystolithiasis and choledocholithiasis[J].China Med Herald, 2013, 10 (10) :40-42. (in Chinese) 刘郁, 于高, 段绍斌.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石临床疗效观察[J].中国医药导报, 2013, 10 (10) :40-42. [4]TOKUMURA H, UMEZAWA A, CAO H, et al.Laparoscopic management of common bile duct stone:Transcystic approach and choledochotomy[J].J Hepatobiliary Pancreat Surg, 2012, 9 (2) :206-212. [5]DECKER G, BORIE F, MILIAT B, et al.One hundred laparoscopic choledochotomies with primay closure of the common bile duct[J].Surg Endosc, 2013, 17 (1) :12-18. -
本文二维码
计量
- 文章访问数: 3024
- HTML全文浏览量: 17
- PDF下载量: 494
- 被引次数: 0
下载:
