中国实用外科杂志

中国实用外科杂志

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三维可视化辅助3D腹腔镜、胆道硬镜肝胆管结石靶向碎石术并发症防治研究

莫志康，方驰华，项    楠，蔡    伟，范应方，杨    剑，曾    宁，刘    军   

  1. 南方医科大学珠江医院肝胆一科，广东广州510282
  • 出版日期:2017-03-01 发布日期:2017-03-02

  • Online:2017-03-01 Published:2017-03-02

摘要：

目的    探讨三维可视化辅助3D腹腔镜、胆道硬镜肝胆管结石靶向碎石术的并发症防治策略。方法    回顾性分析南方医科大学珠江医院2013年11月至2016年5月间收治的57例肝胆管结石病人的临床资料，分析该术式并发症的发生、处理和防治策略。结果    57例病人手术平均时间（171.5±34.7）min。6例发生并发症，其中胆道出血及胆道损伤各2例，胆漏及胃肠道水潴留各1例。所有并发症经积极治疗后痊愈。结论    三维可视化辅助3D腹腔镜、胆道硬镜肝胆管结石靶向碎石术的并发症须根据其发生的原因及时处理，通常可治愈，但应以预防为主。

关键词: 肝胆管结石, 三维可视化, 3D腹腔镜, 胆道硬镜, 并发症

Abstract:

Strategies for preventing the complications of three-dimensional laparoscope combined with rigid choledochoscope lithotripsy guided by three-dimensional visualization technology        MO Zhi-kang,FANG Chi-hua,XIANG nan,et al. The First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University,Guangzhou510282, China
Corresponding author: FANG Chi-hua,E-mail:fangch_dr@126.com
Abstract    Objective    To study the preventive managements of complications in three-dimensional （3D） laparoscope combined with rigid choledochoscope lithotripsy  guided by 3D visualization technology.Methods The clinical records of 57 patients with hepatolithiasis from November 2013 to May 2016 in Zhujiang Hospital，Southern Medical University were collected retrospectively. The occurrence， treatment and prevention of the surgical complications were analyzed.Results    The operating time was（171.5±34.7）min. Surgical complications occurred in 6 cases， including  2 cases of hematobilia and biliary injury，1 case of bile leakage and gastrointestinal water retention. All the complications were cured after active treatments.Conclusion    The complications of 3D laparoscope combined with rigid choledochoscope lithotripsy guided by 3D visualization technology need to be managed promptly according to their causes， usually curable， but the prevention should be stressed with priority.

Key words: hepatolithiasis, 3D visualization;3D laparoscope;rigid choledochoscope, complication