【摘要】 目的探讨腹腔镜胆囊型保留Oddi括约肌的胆管整形皮下盲襻埋置术(Oddi sphincter-preserved cholangioplasty with hepatico-subcutaneous stoma,OSPCHS)微创治疗肝内胆管结石病的疗效。方法 2011年1月~2016年5月我院采用完全腹腔镜胆囊型OSPCHS治疗肝内胆管结石17例,在保留Oddi括约肌的前提下,打开肝门部胆管,形成盆状,胆囊修复胆管前壁,胆囊底部埋置皮下,同时联合行病变肝脏切除术。结果结石清除率82.4%(14/17)。17例术后平均随访38.5月(11~67个月):胆管炎发作1例,复发率5.9%(1/17);3例结石复发(21.4%,3/14),采用小切口盲襻切开、胆道镜取石。结论腹腔镜胆囊型OSPCHS治疗肝内胆管结石病可获得满意的中期疗效。更多还原

【Abstract】 Objective To investigate the efficacy of laparoscopic gallbladder type Oddi sphincter-preserved cholangioplasty with hepaticosubcutaneous stoma( OSPCHS) for hepatolithiasis. Methods From January 2011 to May 2016,17 hepatolithiasis cases had undergone totally laparoscopic gallbladder type OSPCHS in our hospital. With the preservation of the Oddi sphincter,the hepatic duct was opened to make a basin at the porta and repaired by the cholecyst,the fundus of which was set subcutaneously. At the same time,the portion of the damaged liver was resected. Results The complete stone clearance rate was 82. 4%( 14/17). The mean follow-up was 38. 5 months( range,11-67 months) in the 17 cases. One patient( 5. 9%,1/17) suffered from recurrent cholangitis postoperatively. Three patients( 21. 4%,3/14) had stone recurrence,and were treated by cholangioscopy through the hepatico-subcutaneous stoma. Conclusion Laparoscopic gallbladder type OSPCHS is safe,effective and minimally invasive for hepatholithiasis,achieving a satisfactory medium-term results.更多还原