腹腔镜联合胆道镜与开腹手术治疗胆总管结石的系统评价-普通外科(临床医学)专业论文.docxVIP

PAGE PAGE IV Abstract Background Clinically, 15% to 18% of patients with gallstones have common bile duct stones. In the past, for such patients, we used abdominal cholecystectomy and common bile duct T tube drainage.Conventional open surgery for common bile duct showed reliable results, but cholecystectomy still has a lot of blindness. The rate of postoperative residual hepatolithiasis is up to 36.8% even in experienced hospitals.Intraoperative cholangioscopy can reduce the residual rate of bile duct stones, especially when we faced incarceration or basket easy trap of refractory bile duct stones; in that case, shock wave lithotripsy device in body was underwent before lithotripsy stone basket. This showed more significant effect, while avoiding the side injury during blind exploration and reducing reoperation rate of the biliary tract.It plays an important role to use cholangioscopy for improving the surgical treatment of hepatolithiasis. Currently laparoscopic cholecystectomy (LC) has become the Gold standard. Common bile duct stones used to be a contraindication to laparoscopic surgery. In 1991 the first case of laparoscopic cholecystectomy incision with choledochofiberscope lithotomy was performed by Phllip. Since the 21st century, minimally invasive surgical techniques, especially laparoscopic techniques have seen rapid development and have great potential to replace the traditional open surgery in the above areas. Laparoscopic common bile duct, stone extraction choledochofiberscopy and T tube drainage, following the laparoscopic cholecystectomy (laparoscopic cholecystectomy, LC) is another leap forward after the laparoscopic surgery. Objective Meta analysis was used to evaluate clinical effect treatment of common bile duct stones between laparoscopy combined with choledochoscopy and open open surgery. so as to provide some evidence based medicine for similar surgical patients to have a reasonable choice . Methods We searched the Chinese Journal Full-text d