经胆囊管腹腔镜治疗胆总管结石的临床研究

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1、经胆囊管腹腔镜治疗胆总管结石的临床研究【关键词】胆囊【摘要】H的通过比较分析腹腔镜下经胆囊管和经胆总筲切开T管引流两种方法治疗胆囊结石继发胆总管结石的疗效，來评价经内镜治疗的临床价值。方法a2001年3月〜2003年3月对28例病人按胆道探杳途径不同分为经胆囊管组(n=8)和胆总管切开组5=20)。观察二组病例的术后肛门排气吋间、腹腔引流吋间、术后住院日、住院费用及手术并发症发生情况，术后对所有患者进行全程跟踪随访。结果胆总管切开组明显长于或高于经胆囊管组(PvO.05)。手术并发症胆囊管组1例(12.5%);胆总管切开组5例(25.0%),需再次手术治疗的严重并发症2例(10.0%);手术并

2、发症发牛率胆总管切开组明显高于经胆囊管组(PV0.05)。二组患者随访均无胆管狭窄、急性胆管炎及急性胰腺炎的发生和结石复发。结论经胆囊管途径的腹腔镜胆道探查术的胆張结石继发胆总管结冇病人的疗效优于胆管切开T管引流途径的腹腔镜胆道探杏术，值得进一步推广应用。关键词腹腔镜胆道探查术胆总管结石vPstyle—TEXT-INDENT:24pxnalign=center>Aclinicalstudyonlaparoscopictranscysticbileductexplor

3、ationfortreatingthecommonbileductstonesHuangZhongrong,ZhangLeida,PuDezhen,etal.Dept.ofBiliaryandLiverSurgeryofChongQing2ndPeople,sHospital,ChongQing402160.[Abstract]ObjectiveToevaluatetheeffects

4、oflaparoscopictranscysticbileductexplorationtotreatthecommonbileductstones.MethodsFrommarch2001tomarch2003,28patientswithcholecystolithiasisandsec~ondarycommonbileductstonesweretreatedwithlaparoscopiccholedochotomy.Thepatientsweredividedintotwogroups:transcysticgroup(n=8)andcholedochotomygroup(n=20)

5、.Theiralldatawererecordedandstudiedprospectively,andpatientswerefollowedupafterdischarge.ResultsComparedwithcholedochotomygroup,transcys"tiegrouphadlessthetotalquantityofpostoperativetransfusionandhospitalcosts,shorterpostoperativehospitalstay.Theincidenceofpostoperativecomplicationsintranscysticgro

6、upwasl2.5%(l/8)Theincidenceofpostoperativecomplicationsincholedochotomygroupwas25.0%(5/20),andfourofthemwerebiliarycomplications.Theinci~denceofseverecomplicationsthatneenedreoperationswas10.0%(2/20)Therewasnomortalityintwogroups.Con一elusionThetranscysticmethodinlaparoscopiccholedochotomycanavoidthe

7、deficiencyofcholedochotomy,anditisfeasibleandsafeandlowercomplicationsintreatingthecommonbileductstones,soweadvocateitinappropriatecases.Keywordslaparoscopiccholedochotomyco