胆囊管-胆总管骑跨结石的腹腔镜胆囊切除术19例报告-《中国微创外科杂志》

文章信息/Info

Title:: Laparoscopic cholecystectomy for stones straddling between the cystic duct and the common bile duct: Report of 19 cases

Author(s):: ZhuWenyi; Gu Ailin; Bao Yanyi; el al.; Department of General Surgery, Oriental Hospital of Tongji University, Shanghai 200120,China

Keywords:: Laparoscopy; 　Cholecystectomy; 　Stones straddling between the cystic duct and the common bile duct

摘要:: 目的探讨腹腔镜手术处理胆囊管-胆总管骑跨结石的技巧. 方法回顾分析2001年1月～2003年6月19例胆囊管-总胆管骑跨结石行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床资料. 结果 19例腹腔镜下切开胆囊壶腹部和(或)胆囊管,完成LC.结石直径0.4～0.6 cm,平均0.5 cm.术后48 h拔引流管,3～5 d出院.19例随访2～24个月,平均10个月,无残余结石. 结论术中充分显露胆囊管汇入胆总管处,切开胆囊管将结石推挤出胆囊管是腹腔镜下治疗骑跨于胆囊管总胆管间结石的最佳方法,也是预防术后残余结石的最有效手段.

Abstract:: Objective　To investigate the surgical techniques of laparoscopic procedures in the management of stones straddling between the cystic duct and the common bile duct.　M ethods　Clinical data of 19 cases of stones straddling between the cystic duct and the common bile duct treated by laparoscopic cholecystectomy (LC) from January 2001 to June 2003 were retrospectively reviewed.　Results　The operationswere completed by opening the gallbladder ampulla and/or the cystic duct in all the patients. The stoneswere 0·4~0·6 cm in diameter (mean, 0·5 cm).The drainage was removed 48 hours ofter the surgery.The patientswere discharged from hospital3~5 days postoperatively. Follow-up checkups in the 19 cases for 2~24 months (mean, 10 months) found no residual stones.　Conclusions　Thorough exposure of the union of the cystic ductwith the common bile duct and the opening of the cystic duct to expel the stones is the bestway tomanage stones straddling between the cystic duct and the common bile ductunder laparoscope, and also themost effectivemethod to preventpostoperative residual stones.