腹腔镜联合胆道镜行胆总管切开取石探查术156例临床体会

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1、腹腔镜联合胆道镜行胆总管切开取石探查术156例临床体会【摘要】目的：总结腹腔镜联合胆道镜行胆总管切开探查取石、T管引流术的临床体会。方法：先行腹腔镜胆囊切除术，再切开胆总管，用特制的腹腔镜胆总管取石钳取石，胆道镜主要观察胆总管及肝内外胆管有无结石残余及是否通畅，必要时经胆道镜取石。结果：术后拔T管时出现胆漏3例，1例术后10dT管自胆总管脱出至腹腔，1例术后24h胆漏达400ml,例中转开腹，余均痊愈出院，无残石及术后胆管狭窄等并发症发生。结论：腹腔镜联合胆道镜行胆囊切除、胆总管切开探查取石、T管引流术具有安全可靠、患

2、者损伤小、康复快、住院时间短等优点，是治疗胆囊结石、胆总管结石的有效术式。【关键词】腹腔镜术胆道镜胆总管结石Laparoscopecombinedwithcholedochoscopeincholedochotomyforstoneremovalandexplorationfor15cases　　【Abstract】Ｏbjective:Tosummarizetheclinicalexperienceoflaparoscopecombinedwithcholedochoscopeincholedochotomyforex

3、ploration,stoneremovalandTtube:Usingspeciallaparoscopiclithotomyforcepstoremovecalculusfrom腹腔镜联合胆道镜行胆总管切开取石探查术156例临床体会【摘要】目的：总结腹腔镜联合胆道镜行胆总管切开探查取石、T管引流术的临床体会。方法：先行腹腔镜胆囊切除术，再切开胆总管，用特制的腹腔镜胆总管取石钳取石，胆道镜主要观察胆总管及肝内外胆管有无结石残余及是否通畅，必要时经胆道镜取石。结果：术后拔T管时出现胆漏3例，1例术后10dT管自胆总管

4、脱出至腹腔，1例术后24h胆漏达400ml,例中转开腹，余均痊愈出院，无残石及术后胆管狭窄等并发症发生。结论：腹腔镜联合胆道镜行胆囊切除、胆总管切开探查取石、T管引流术具有安全可靠、患者损伤小、康复快、住院时间短等优点，是治疗胆囊结石、胆总管结石的有效术式。【关键词】腹腔镜术胆道镜胆总管结石Laparoscopecombinedwithcholedochoscopeincholedochotomyforstoneremovalandexplorationfor15cases　　【Abstract】Ｏbjective:T

5、osummarizetheclinicalexperienceoflaparoscopecombinedwithcholedochoscopeincholedochotomyforexploration,stoneremovalandTtube:Usingspeciallaparoscopiclithotomyforcepstoremovecalculusfromcommonbileductafterlaparoscopiccholecystectomyandwasmainlyusedtoobservewhether

6、ornottherewasanycalculileftandthepatencyofthecommonbilenecessary,choledochoscopecouldtakethecalculiout.Results:AftertheremovalofTtube,bileleakageoccurredinpatients,1caseinthetenthdayafteroperation,Ttubeprolapsedtoabdomen,1caseinthe4haftertheoperation,400mlbile

7、leaked,caseswereconvertedtoopenoperation,alltheotherswerehealedwithoutanycomplicationssuchascalculileft,biliarystrictureandso:Laparoscopecombinedwithcholedochoscopeinlaparoscopiccholecystectomyandcholedochotomyforexploration,stoneremovalandTtubedrainageissafean

8、dinpatientsareminor,whorecovermorequicklyandwithshorterhospitalizationmethodisfeasibleintreatmentofcalculiingallbladderandbileduct.　　【Keywords】Laparoscopy;Choledochos