【摘要】 目的探讨腹腔镜下经胆囊管纤维胆道镜(纤胆镜)探查取石术治疗继发性胆总管结石。方法1998年8月～2006年12月,选择性对30例胆囊结石合并继发性胆总管结石患者行腹腔镜下经扩张的胆囊管纤胆镜探查取石术,胆囊管较细、取石困难的沿胆囊管向胆总管斜纵向切开,取净结石后腔内缝合。结果6例胆道探查阴性,24例有胆总管结石,全部取净,取净率为100%。手术时间60～220min,平均105min。无胆漏、腹膜炎等并发症发生。随访0.5～5.0年,平均3年,无残余结石和胆道狭窄等并发症。结论腹腔镜下经胆囊管纤胆镜探查取石术是微创治疗胆囊结石继发性胆总管结石的理想手术方式,安全可行。更多还原

【Abstract】 [Objective] To discuss techniques and effects of stone extraction by fibrocholedochoscopy through cystic duct under laparoscope in treatment for the secondary choledocholith. [Methods] Clinical records of the applications of fibrocholedochoscopy process the dilated cystic duct to cure the secondary choledocholith under laparoscope in 30 patients between August 1998 and December 2006 were analyzed retrospectively. [Results] 6 cases are negative. Stones were completely removed intraoperatively in all 24 with choledocholith. The operative length was 60~220 min (mean 105 min). During a follow-up for 0.5~5 years in all the patients, no residual stones or biliary stricture were found. [Conclusions] Fibrocholedochoscopy process the cystic duct in laparoscope for calculus cholecystitis combined with choledocholithasis is safe and effective.更多还原