【作者】 汤可立； 石承先； 徐贤刚； 赵鹏伟； 李克跃；

【Author】 TANG Ke-li,SHI Cheng-xian,XU Xian-gang,ZHAO Peng-wei,LI Ke-yue Department of the Hepatobiliary Surgery.The Guizhou Provincial People’s Hospital Guiyang Guizhou 550002.China.

【机构】 贵州省人民医院肝胆外科；

【摘要】 目的:探讨腹腔镜下胆总管探查取石、一期缝合并胆道内双J管内引流术的可行性和临床疗效。方法 :回顾性分析我院2008年9月至2012年5月收治的45例胆总管直径大于8mm的胆总管结石患者施行腹腔镜下胆囊切除、胆总管切开、胆道镜取石、胆道内双J管内引流术,总结该术式的适应证、操作技术及临床疗效。并将之与其它术式进行比较分析。结果:45例患者中42手术获成功,1例中转开腹,2例改成放T管,术中取尽结石,术后未发现胆漏、胆道狭窄或残余结石。胆道内双J管40例于术后5-7天在胃镜下拔出,2例在术后1周内随大便自行排出。结论:对于胆总管直径大于0.8cm,胆囊结石合并胆总管结石的病例,腹腔镜下胆总管切开探查取石、胆总管一期缝合、双J管内引流术是可行的,能缩短住院时间,降低医疗费用。更多还原

【Abstract】 Objective:To explore the feasibility and clinical effectiveness of common bile duct exploration,primary suture of common bile duct and biliary stent drainage with double J tube by laparoscope.Methods:From Sep.2008 to May.2012,45 patients of common duct stones whose common bile duct diameter greater than 8 mm were enrolled in this study,and were compared to other surgical procedures.Results:The procedure was accomplished in all 42 patients except 3 patient with no residual stones,no bile fistula and no biliary stricture.The double J tube was drew out by gastroscope in 40 cases,and the remaining 2 stents were excreted by stool 1 week after operation.Conclusions:It is feasible to perform laparoscopic common bile duct exploration and stone removal,biliary stent drainage with double J tube and primary suture of common bile duct for the patient of cholecystolithiasis merger choledocholithiasis,whose common bile duct diameter greater than 8 mm.Compared with other minimally invasive procedures,it is a effective method and can shorten hospital stay,decrease the medical cost.更多还原