胆管结石行腹腔镜联合胆道镜治疗可行性分析.docVIP

胆管结石行腹腔镜联合胆道镜治疗可行性分析 　　【摘要】 目的：探析腹腔镜联合胆道镜治疗胆管结石的临床效果和可行性。方法：选取2013年10月-2014年10月本院收治的行腹腔镜联合胆道镜治疗的胆管结石患者75例作为研究对象，回顾性分析其资料。结果：75例患者均成功完成手术，无一例中转开腹手术，其中行胆总管一期缝合15例，占20%，行T管引流60例，占80%；平均手术用时（103.5±35.4）min；平均术中出血量为（93.5±19.3） mL；平均胃肠道功能恢复时间为（1.6±1.1） d；平均住院时间为（8.7±3.5） d；术后出现1例胆漏，经腹腔引流后痊愈；3例胆道残石，经T管胆道镜下完成取石，所有患者均康复出院；术后随访6～10个月，无患者复发。结论：临床上运用腹腔镜联合胆道镜治疗胆管结石，是比较可靠和有效的一种方法。 　　【关键词】 胆管结石； 腹腔镜； 胆道镜； 可行性 　　【Abstract】 Objective：To analyze and discuss the clinical effect and feasibility of laparoscopy combined with choledochoscopy in treatment of bile duct stones.Method：A total of 75 cases of laparoscopy combined with choledochoscopy in treatment of bile duct stones from October 2013 to October 2014 in our hospital were selected as the research objects，retrospective analysis was performed.Result：All patients were successfully completed surgery，and 1 cases without conversion to open surgery.One stage suture for bile duct was 15 cases，accounting for 20%，and for T tube drainage was 60 cases，accounting for 80%.The mean operative time was （103.5±35.4） min，the average amount of bleeding was （93.5±19.3） mL，the average recovery time of gastrointestinal function was （1.6±1.1） d，the average hospitalization time was （8.7±3.5） d.Postoperative bile leakage was 1 cases，it recovered after abdominal drainage.3 cases of biliary residual stones by choledochoscope via T tube completion of stone，all patients were discharged.Patients were followed up for 6 to 10 months without recurrence.Conclusion：Clinical application of laparoscopy combined with choledochoscopy in treatment of bile duct stones is a reliable and effective method. 　　【Key words】 Bile duct stones； Laparoscope； Choledochoscope； Feasibility 　　First-author’s address：The Central Hospital in Baoan District of Shenzhen City，Shenzhen 518102，China 　　doi：10.3969/j.issn.1674-4985.2016.12.037 　　胆管结石是比较常见的一种胆道外科疾病，也是导致急腹症的一个重要原因，临床表现以高热、黄疸及腹痛等症状为主，严重的情况下，易出现休克或者精神症状[1]。临床上在对胆管结石进行治疗时，开腹手术是比较传统的一种方式，虽然疗效确切，但是创伤大、出血量多，随着腹腔镜技术的不断发展，传统开腹手术逐渐