中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (02): 152-153.

• 论著 • 上一篇    下一篇

腹腔镜手术治疗胆囊管结石76例分析

唐湘莲，蒋平，李利义，金洲祥   

  1. 温州医学院附属第二医院普外科，浙江温州 325000
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-03-03 发布日期:2009-03-03

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-03-03 Published:2009-03-03

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摘要：

目的 探讨胆囊管结石的诊断及腹腔镜手术的处理方法。 方法 对2002年7月至2008年1月温州医学院附属第二医院外科诊治76例胆囊管结石行腹腔镜胆囊切除术的临床资料进行回顾性分析。 结果 经B超、CT术前诊断胆囊管结石26例，术中探查发现胆囊管结石50例。顺利完成腹腔镜胆囊切除术（LC）74例，2例中转开腹。未发生胆管损伤、出血、胆漏、胆总管结石等严重并发症，均痊愈出院。 结论 B超结合CT检查可在术前发现部分胆囊管结石，术中仔细探查也可减少遗漏胆囊管结石。术中警惕胆囊管结石的存在，灵活运用LC的处理技巧是腹腔镜胆囊管结石手术成功的关键，择机中转开腹可减少不必要的胆管损伤。腹腔镜胆囊管结石手术是安全可行的。

关键词: 胆囊管结石, 腹腔镜胆囊切除术

Abstract:

Laparoscopic surgery in the treatment of calculus of cystic duct: an analysis of 76 cases TANG Xiang-lian, JIANG Ping, LI Li-yi, et al. Department of General Surgery, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China Corresponding author：JIANG Ping, E-mail：jiangstjst@163.com Abstract Objective To explore the diagnosis and laparoscopic surgery therapy for calculus of cystic duct. Methods The clinical data of 76 cases of calculus of cystic duct performed laparoscopic cholecystectomy (LC) between July 2002 and January 2008 at the Second Affiliated Hospital of Wenzhou Medical College were analyzed retrospectively. Results Twenty-six cases were given preoperative diagnosis by B-ultrasound and CT. For other 50 cases, stones were found by exploration in operation. Seventy-four cases underwent LC successfully and 2 got conversion to open surgery. All cases recovered completely and discharged without bile duct injury, hemorrhage, bile leakage, common duct stones or other severe complications. Conclusion B-ultrasound combined CT could discover part of calculus of cystic duct before operation, then careful exploration in operation could reduce omission. The key to a successful laparoscopic surgery includes notice of calculus of cystic duct in operation and flexible application of LC skills to treat duct of gallbladder. Timely conversion to open surgery could reduce unnecessary injury of bile duct and vascular. Laparoscopic surgery for calculus of cystic duct is a feasible and safe optional therapy for calculus of cystic duct.

Key words: calculus of cystic duct, laparoscopic cholecystectomy