双镜联合一次性治疗胆囊结石并发胆总管结石的临床研究

摘要:目的 探讨应用腹腔镜、十二指肠镜联合同期一次性治疗胆囊结石合并胆总管结石的可行性.方法 2009年11月至2012年3月,对150例胆囊结石合并胆总管结石的患者采用双镜同期治疗.即在手术室在全身麻醉下先行腹腔镜胆囊切除术(LC),随后行内镜逆行胆胰管造影(ERCP),采用乳头括约肌切开(EST)或球囊扩张(EPBD)取石,然后放置鼻胆管引流(ENBD).观察疗效和并发症发生情况.结果 150例患者均成功完成LC和ERCP操作,术中术后未发生出血、穿孔、重症胰腺炎等严重的并发症.术后胃肠功能恢复时间及住院时间短.术后随访期间行腹部B超检查,均未发现胆总管残留结石或再生结石.结论 在同一次麻醉下同期完成LC和ERCP是安全可行的,具有创伤小、恢复快等优点.
Objective To investigate the feasibility of laparoscopy with simultaneous ERCP for cholecystolithiasis combined with common bile duct stones.Methods The clinical data of 150 cases with combined choledocholithiasis and cholecystolithiasis who underwent laparoscopy and simultaneous ERCP from November 2009 to March 2012 were analyzed retrospectively.Under general anesthesia,laparoscopic cholecystectomy (LC) was performed and followed by ERCP.Common bile duct stones were removed by ERCP and endoscopic nasobiliary drainage (ENBD)was placed.Therapeutic effect and complications were observed.Results LC and ERCP were successfully completed in all patients.There was no bleeding,perforation,severe pancreatitis or other severe complications occurred in any patient during and after operation.Postoperative gastrointestinal function recovery time and hospitalization were short.During follow-up,no residual or recurrent stones were found by abdominal ultrasound examination.Conclusion Simultaneous ERCP and laparoscopy is effective and safe treatment with less invasiveness and quick recovery for cholecystolithiasis combined with choledocholithiasis.

英文标题Laparoscopy with simultaneous ERCP for cholecystolithiasis combined with choledocholithiasis
关键字胆囊切除术,腹腔镜,胰胆管造影术,内窥镜逆行,胆囊结石病,胆总管结石
作者侯波,黄博,徐钧,陈星,张晶,王志峰
所属期刊栏目论著,Original Articles
刊名中华消化内镜杂志,Chinese Journal of Digestive Endoscopy
作者单位王志峰:山西省人民医院消化内镜诊断治疗中心,太原,030012,陈星:山西省人民医院消化内镜诊断治疗中心,太原,030012,黄博:山西省人民医院消化内镜诊断治疗中心,太原,030012,张晶:山西省人民医院消化内镜诊断治疗中心,太原,030012,徐钧:山西省人民医院消化内镜诊断治疗中心,太原,030012,侯波:山西省人民医院消化内镜诊断治疗中心,太原,030012
DOI10.3760/cma.j.issn.1007-5232.2012.11.008
SSSN1007-5232

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