腹腔镜联合胆道镜治疗复发胆管结石的临床体会

摘要

目的 探讨腹腔镜联合胆道镜治疗复发胆管结石的临床可行性与安全性.方法 回顾性分析2013年1月至2015年1月华中科技大学同济医学院附属荆州医院收治的90例因复发胆管结石施行腹腔镜下胆总管探查、胆道镜取石病人的临床资料.结果 90例病人中86例成功施行腹腔镜手术,其中4例中转开腹.手术时间为(123.0±34.6)min,术中胆道取石时间为(64.0±12.4)min,术中出血量为(31.4±13.5) ml,术后平均住院时间为(6.8±2.5)d.围手术期主要并发症是胆漏.所有病人随访期内无结石复发,无胆管狭窄发生.结论 腹腔镜联合胆道镜治疗复发胆管结石是安全有效的,应作为复发胆管结石再手术的首选手术方式.%Objective To investigate the clinical safety and feasibility of laparoscope combined with choledochoscope in the treatment of recurrent bile duct stones.Methods The clinical data of 90 patients with recurrent bile duct stones who received laparoscopic common bile duct exploration combined with choledochoscope at the Jingzhou Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology from January 2013 to January 2015 were retrospectively analyzed.Results Eighty-six cases were successfully subjected to laparoscopic operation and 4 cases were required conversion to laparotomy.The operation time was (123.0 ± 34.6) min,the time for biliary stone removal was (64.0 ± 12.4) min,and the volume of intraoperative hemorrhage was (31.4 ± 13.5) mL.The postoperative hospital stay was (6.8 ± 2.5) days.The major complication was biliary leakage perioperatively.All the patients recovered well without stone recurrence and bile duct stricture during the follow-up period.Conclusions Laparoscope combined with choledochoscope in the treatment of recurrent bile duct stones is safe and effective.This method should be the preferred operation for those patients.