【摘要】 目的:探讨腹腔镜下经胆囊管胆道镜肝内外胆管探查(transcystic laparoscopic combined choledochoscopic extraand intrahepatic bile duct exploration,TC-LCBDE)的可行性及其应用价值。方法:回顾分析2010年1月至2015年12月在腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中行胆道探查患者的临床资料。结果:共125例患者于LC术中行胆道镜胆管探查术,其中32例行TC-LCBDE,手术时间平均(85±38)min。其中3例术中改为胆总管切开胆道镜探查取石术,术中留置T管引流;2例因十二指肠乳头水肿导致乳头开口狭窄,予以胆总管切开留置T管引流;其余27例均成功完成TC-LCBDE,术中未放置T管,平均住院(4.6±1.8)d,术后随访未见并发症。结论:TC-LCBDE操作有一定难度,但选择合适病例,度过学习曲线后,可顺利完成此术式,减少了术后并发症的发生,提高了患者的生活质量,具有较好的推广价值。更多还原

【Abstract】 Objective: To discuss the feasibility and value of transcystic laparoscopic combined choledochoscopic extra-and intra-hepatic bile duct exploration( TC-LCBDE). Methods: Retrospective analysis was made on the clinical data of patients undergoing laparoscopic bile duct exploration in laparoscopic cholecystectomy( LC) from Jan. 2010 to Dec. 2015. Results: A total of 125 patients underwent choledochoscopic bile duct exploration in LC,and 32 patients of them were performed TC-LCBDE. The operation time was( 85 ± 38) min. 3 patients of these 32 patients were converted to choledochoscopic bile duct exploration via common bile duct,T tube was placed; 2 patients also indwelled T tube via common bile duct because of duodenal papilla edema and stenosis after TC-LCBDE.Other 27 patients were successfully performed TC-LCBDE without indwelling T tubes. The hospital stay was( 4. 6 ± 1. 8) d,and there were no postoperative complications. Conclusions: Thought it is difficult to perform TC-LCBDE,if selecting patients suitably and training enough,TC-LCBDE could be finished successfully,and patients could benefit from the operation.更多还原