十二指肠镜、腹腔镜联合治疗肝外胆管结石
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霍新合

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Combined use of duodenoscopy and laparoscopy for treatment of calculus of extrahepatic bile duct
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    摘要:

    目的:探讨十二指肠镜联合腹腔镜治疗胆囊结石并胆管结石的临床效果。
    方法:回顾分析7年间106例胆囊结石并胆管结石患者的临床资料。106例均先行内镜下十二指肠乳头切开(EST)取石、鼻胆引流(ENBD)然后行腹腔镜胆囊切除术(LC)。
    结果:EST取石成功101例(95.3 %);并发症包括胰腺炎(高淀粉酶血症)11例(10.4 %),出血1例,急性胆管炎2例,均经对症处理治愈。全组病例无死亡,均痊愈出院。85例获平均3.1年随访,术后复发胆管结石5例(5.9 %),十二指肠乳突部再狭窄1例;另发生胆管癌2例,其他原因死亡2例。
    结论:联合EST和LC治疗肝外胆管结石是一种安全有效的微创手术方法。

    Abstract:

    Abstract:Objective:To discuss the clinical effect of combined use of duodenoscopy and laparoscopy for treatment of cholecystolithiasis complicated by choledocholithiasis.
    Methods :The clinical data of 106 cases of cholecystolithiasis with cholelcoholithiasis in our department during 7 years were analyzed.Endoscopic sphincteromy (EST) and endoscopic nasobiliary drainage (ENBD), followed by laparoscopic cholecystectomy(LC) was employed.
    Results:In 101 cases(95.3 %) stones were removed by EST successfully. Complicated with postoperative pancreatitis in 11cases(10.4 %), bleeding in 1 case (0.9 %), and acute cholangitis in 2 cases (1.9 %). All of the patients recovered and discharged. Eighty-five cases were followed up for average 3.1 years. Of them, 5 cases had choledocholithiasis recurrence, 1 had papillary re-stenosis, 2 had bile duct carcinoma, and 2 died of other caused.
    Conclusions:Combined use of EST and LC for treatment of calculus of extrahepatic bile duct is a safe and effective mini-intrusive operation.

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霍新合.十二指肠镜、腹腔镜联合治疗肝外胆管结石[J].中国普通外科杂志,2007,16(12):4-114.
DOI:10.7659/j. issn.1005-6947.2007.12.004

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  • 在线发布日期: 2007-12-25