腹腔镜再次胆道手术的处理-《中国微创外科杂志》

文章信息/Info

Author(s):: Zhu Andong; Chen Dexing.; Department of General Surgery, Jilin Province Qianwei Hospital, Changchun 130021, China

摘要:: 目的探讨经腹腔镜再次胆道手术的可行性及临床疗效。方法2000年5月~2007年5月，共行腹腔镜再次胆道手术105例，包括经腹腔镜再次胆总管切开取石、T管引流术96例，胆/肝管-空肠RouxenY吻合术5例，肝叶切除术4例。结果105例手术均成功，无严重并发症发生。手术时间60～185 min，（125.3±23.2）min。术中出血15～310 ml，（21.1±8.6）ml。术后住院5～9 d。胆肠RouxenY吻合术5例，术后随访6～65个月，（132±86）月，未见结石复发；肝左叶及右叶部分切除各2例，术后随访8～25个月，（102±36）月，未见结石复发；腹腔镜胆总管切开取石、T管引流术96例，随访3～72个月，（132±96）月，未见结石复发。结论经腹腔镜胆道再次手术安全、有效，能达到微创手术的治疗效果。

Abstract:: ObjectiveTo evaluate the feasibility and clinical efficacy of laparoscopic biliary reoperation.MethodsFrom May 2000 to May 2007, 105 patients received laparoscopic biliary reoperation, including choledocholithotomy and Ttube drainage in 96 cases, RouxenY anastomosis of the gallstone/hepaticduct in 5, and liver resection in 4.ResultsThe operations were completed in all the 105 patients without severe complications. The operation time was 60-185 min ［mean, (125.3±23.2) min］. Intraoperative blood loss was 15-310 ml ［mean, (21.1±8.6) ml］. The patients stayed at hospital for 5-9 days after the operation. The 5 patients, who underwent RouxenY anastomosis of the gallstone/hepaticduct, were followed up for 6 to 65 months ［mean, (13.2±8.6)months］. Partial liver resection was performed in 2 cases (resection of the left hepatic lobe in 2, and the right lobe in 2); they were followed up for 8-25 months ［mean, (10.2±3.6)months］. In the 96 patients, who received laparoscopic choledocholithotomy and Ttube drainage, the followup were lasted for 3-72 months ［mean, (13.2±9.6)months］. None of the patients who were followed up had recurrence of gallbladder stone.ConclusionsLaparoscopic biliary reoperation is feasible and safe with minimal trauma to patients.