胆总管结石；腹腔镜；胆总管探查；胆道取石；T管引流_

改进的腹腔镜胆总管探查方法可行性探讨

http://www.100md.com 《腹腔镜外科杂志》 2006年第5期

胆总管结石；腹腔镜；胆总管探查；胆道取石；T管引流,,胆总管结石；腹腔镜；胆总管探查；胆道取石；T管引流,1资料与方法,2结果,3讨论,参考文献：

     【摘要】目的：探讨改进的腹腔镜胆总管探查方法的可行性。方法：改剑突下孔(B孔)横行切口为纵行。不必将纤维胆道镜列为必备器械。常规胆道取石钳及取石网蓝可直接进入胆道取石，必要时探子经B孔进入胆道下段扩张Oddi括约肌，其余方法与常规相同。结果：31例中1例疑探子“穿破”胆道下段而中转开腹，经查无误后T管引流。2例术后出现胆漏，经引流5d治愈。平均住院7d。4周后造影拔管。30例均无残石。结论：改进的胆总管探查方法不需特殊器械，操作简便、易行、安全。

    【关键词】胆总管结石；腹腔镜；胆总管探查；胆道取石；T管引流

    The study of the feasibility of improved laparoscopic bile duct exploration

    LIANG Jiuyin,LI Kailang,DAN Zhenyu,et al.

    Dept.of General Surgery,Anhui Provincial Corps Hospital,Chinese People's Armed Police Forces,Hefei 230041,China

    【Abstract】 Objective:To discuss the feasibility of improved laparoscopic bile duct exploration.Methods:The procedures were performed without choledochofiberscopy,by changing horizontal incision into microtubule incision of subxiphoid process port(B port),using choledochoscopic netbasket and routine laparotomic instruments to remove stone.Results:In the 31 cases,1 case required conversion to open operation and laying up Ttube due to suspiction of lower level bile duct injury.Among other 30 cases,2 cases of biliary fistula recovered by abdominal drainage tube for 5 days,and all 30 cases removed Ttube after biliarygraphy without residual choleiith.Conclusions:Improved laparoscopic bile duct exploration without choledochofiberscopy is easy and safe. ......

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