两镜联合辅助小切口治疗肝内外胆管结石的临床研究
【摘要】目的：探讨两镜联合(腹腔镜、纤维胆道镜)辅助小切口治疗肝内外胆管结石的适应症、手术方法和临床效果；方法：回顾33例患者利用腹腔镜、纤维胆道镜辅以3-5cm小切口行胆囊切除、胆总管切开取石T管引流术。结果：33例肝内外结石患者均在两镜联合辅助小切口下完成手术，无一例因特殊情况中止腹腔镜手术转为传统开腹(大切口)手术。平均手术时间90min，术后1-2天进食流质及下床活动，4-7天出院，无一例出现胆瘘、出血等并发症。讨论：两镜联合辅助小切口的手术方式，扩大了微创腔镜手术的适应症，解决了复杂肝内外胆管结石的各种手术难点。【关键词】腹腔镜；纤维胆道镜；小切口；胆总管切开取石T管引流
【Abstract】Objective:Toinvestigatetheindication,Surgicalmethods,clinicresultsofSurgicalTreatmentwithCombinationofEndoscope(LaparoscopicandCholedochofiberscope)assistedbymini-incisionforIntrahepaticandExtrahepaticBiliDuctStoneDisease;Methods:Theclinicaldataof33casewithCholecystectomy,CholedocholithotomyandT-tubeDrainagebyCombinationofEndoscope(LaparoscopicandColedochofiberscope)assistedbymini-incision(3-5cm)wereanalyzedetrospectively.Results:AlltheminimallyinvasivesurgeryweresuccessfullyperformedandnoonewereconvertedtoConventionalOperation(largeincision).Themeanoperationtimewas90minutes.Thepatientscouldactonfloorandtakeliquidfoodafter1-2days,andleavein4-7days.Complicationswerenocasesofbiliaryfistula,Hemobiliaandsoon.Conclution:thesurgicalprocedureofCombinationofEndoscopeassistedbymini-incisionexpandstheindicationsofminimallyinvasiveendoscopeoperation,andsolvesthedifficultiesofsurgeryforcomplexIntrahepaticandExtrahepaticBiliDuctStoneDisease ......
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