术中纤维胆道镜经胆囊管行胆总管取石的技巧.pdfVIP

第14卷第2期 中国内镜杂志 Vo1．14 No．2 2008年2月 China Journal of Endoscopy Feb．2OO8 文章编号： 1007—1989(2008)02—0188—03 术中纤维胆道镜经胆囊管行胆总管取石的技巧 王京立，俞宪民，潘兆麟，杨敖霖，顾元龙，吴小龙 (江苏省无锡市第三人民医院，江苏 无锡 214041) 摘要：目的 探讨开腹和腹腔镜胆囊切除术中纤维胆道镜经胆囊管行胆总管取石的可行性。方法 总结两 组共113例中成功102例的经验和体会，就选择标准、操作技巧和防治并发症等方面提出见解。结果 开腹组 84例，6例改变术式；腹腔镜组29例，5例改变术式。手术时间：开腹组(90±20)min，腹腔镜组(110 q-30)ⅡliIl。 胆总管直径0．8～1．7 cm，取出结石1～7枚，直径0．3～1．0 cm。术后放置腹腔引流管2～6d，发生漏胆7例，引 流胆汁5～100mL／d。无因漏胆再次手术病例，无腹腔感染及手术死亡病例。93例随访0．5～1．0年，胆总管残余 结石3例。结论 两种术式的胆道镜经胆囊管行胆总管取石都是可行的。腹腔镜胆囊切除术中纤维胆道镜经胆 囊管行胆总管取石具有减少创伤、缩短住院日、无T管并发症等优点。尤其适用于胆总管继发结石的治疗。 关键词：胆管结石；纤维胆道镜；胆囊管；外科手术 中图分类号： K657．42 文献标识码：B rn。1’ecluucs 0t extraCn0n 0I C0mm0n Dlle nUCt CalCUll m ’ ‘ n · J● ●● 1 ●1 1 J 1 1● J1r0U cystic duct by using fiberch0led0ch0sc0py WANG Jing—Li，YU Xian-Min，PAN Zhao—lin，YANG Ao—lin，GU Yuan—long，WU Xiao—long r Third People s Hospital,Wuxi,Jiangsu 214041，P．R．China) Abstract：【Objective】To explore the technics of extraction of common bile duct calculi through cystic duct by fit~rcholedochoscopy during operation．【Methods】113 patien~ tIl common bile butt calculi undergoing extrac— tion of the common bile duct calculi were analyzed retrospectively． All patien~had operations to extract common bile duct calculi through cystic duct by fibercholedoehoscopy in laparotomy(Group LT，n=841 or by laparoscopic operation(Group LC，n=29)．【Result】The surgery were successfully perfermed on 78 patien~(92．9％)in Group LT and 24 patien~(82．8％、in Group LC．The time of operation were 90+，-2O min and 1 1O+，一30 min respectively in Group LT and Lc． The diameter of the co