目的 总结采用腹腔镜联合输尿管软镜经胆囊管行胆总管探查术的临床体会. 方法 2013年3月～2015年7月采用腹腔镜联合输尿管软镜经胆囊管有选择地对35例患者行胆总管探查术.胆囊结石并胆囊炎35例,胆总管结石29例,胆总管内径0.6～1.5 cm. 结果 35例腹腔镜联合输尿管软镜经胆囊管胆总管探查术均手术成功,无中转开腹,术后均未置管,取净胆总管结石29例,探查阴性6例,患者术后恢复好,无残留结石.3例术中发现胆总管增宽.术后均未出现胆漏、发热、黄疸及胰腺炎等并发症. 结论 在合理选择适应证条件下,腹腔镜联合输尿管软镜经胆囊管行胆总管探查术是微创、安全、有效的.%Objective To summarize the experience of transcystic common bile duct exploration under laparoscope and ureteroscope with soft lens.Methods From March 2013 to July 2015,a total of 35 cases were performed transcystic common bile duct exploration under laparoscope and soft ureteroscope.There were cholecystolithiasis and cholecystitis in 35 cases and choledocholith in 29 cases.The inner diameter of common bile duct ranged from 0.6 to 1.5 cm.Results The common bile duct exploration was accomplished successfully in all 35 cases without intra-operative conversion.29 cases of choledocholith were achieved stones free,and 6 cases of negative stones were received exploration.All cases were restored well without residual calculi.No post-operative complication as bile leakage,fever,jaundice and pancreatitis occurred.Conclusion The surgical intervention of transcystic common bile duct exploration under laparoscope and soft ureteroscope is mini-trauma,safe and effective for suitable patients.
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