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1、腹腔镜联合胆道镜迷你微创保胆取石68例报道胡海*所广军*黄安华*王维东*忻颖*同济大学附属东方医院微创外科【摘要】 目的:探讨联合应用腹腔镜与胆道镜技术行迷你微创保留胆囊治疗胆囊结石的可行性及临床应用价值。方法:总结68例采用迷你微创腹腔镜和胆道镜联合技术保胆手术的临床资料。结果:手术时间平均65min(45-90mm),术后只有3例感到脐部戳孔疼痛使用止痛剂。病人当天均可下床,次日进食流质,1-3天出院。无术后出血、胆漏、切口感染及其他并发症。门诊随访1-19个月,尚未见结石复发。结论:腹腔镜联合胆道镜微创保胆取石技术是一种安全可行的胆囊结石
2、治疗方法,具有对人体创伤小和美容效果好等优点。【关键词】 腹腔镜;胆道镜;胆囊取石LaparoscopeandcholedochoscopeincombinationforremovalofgallbladderstonesHaiH,Guang-JunSuo,An-HuaHuang,etal.ShanghaiEastHospitalAffiliatedtoTongjiUniversity,Shanghai,China【Abstract】ObjectiveToinvestigatethefeasibilityandsafetyofremoving
3、gallbladderstonesbylaparoscopeandcholedochoscopeincombination.Methods68casesofgallstonepatientswhoweretreatedbyremovinggallbladderstonesusinglaparoscopeandcholedochoscopeincombinationwereretrospectivelyanalyzed.locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassa
4、ssination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcameResultsAllthepatientsexperiencedsuccessfulcholecystolithotomywithoutanyperi-operativecomplicatons.Theoperationtimewas65min(45-90min).Only3p
5、atientsaskedforpainkillerduetointolerablepainintheumbilicus.Follow-upfor1-19months,nostonerecurrencewasfound.ConclusionsThecombinationoflaparoscopewithcholedochoscopeforcholecystolithotmyisasafeandfeasiblemethodofgallbladderstonetreatmentwithmeritsoflesstraumatothepatientsan
6、dgoodcosmeticresulttopatient’ssatisfactory.【Keywords】Laparoscope;Choledochoscope;cholecystolithotomy多年来胆囊切除一直被人们尊为治疗胆囊结石的“金标准”[1]。然而基于对胆囊功能认识的深入,人们也不断在挑战这一理论,采用多种方法在去除胆囊结石时尝试保留胆囊功能,包括有口服溶石、中药排石、体外冲击波碎石及胆囊取石等,但多数都因结石高复发率而失败,这也为胆囊切除的盛行提供了佐证。然而随着现代科技的不断发展,内镜技术的进步,促使人们再一次聚焦保胆手术。
7、不多文献的报道结果使我们看到了其潜在的临床价值[2],并鼓舞我们探讨更佳的手术术式。以下是我们应用新式术式行保胆手术的资料及经验总结。病人与方法locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame自20
8、07年3月至2008年11月共收治68例胆囊结石病人,其中女55例,男13例,平均年龄47(35-56岁)。经术前B超和口服胆囊造影示胆囊收缩和浓缩功