摘要
目的：探讨双镜联合完全腹腔内微创保胆取石术的手术指征、手术技巧及术后预防措施。方法：回顾分析2013年11月至2014年5月为15例患者行微创保胆取石术的临床资料。结果：1例术中发现胆囊炎症重,改行腹腔镜胆囊切除术;1例术中发现胆囊周围粘连严重,改行开腹胆囊切除术;余13例均成功完成保胆取石术。手术时间30-150 min,平均（74.3±34.7）min;术中出血量5-15 ml,平均（9.8±2.9）ml。术后无明显并发症发生。患者均于术后第2天下床活动,24 h后进流质饮食。术后住院4-6 d,平均（4.8±0.8）d。术后1-2个月复查B超,均无结石残留。13例随访6-12个月,无结石复发,胆囊功能良好。结论：双镜联合完全腹腔内保胆取石微创、生理优势明显,术前综合评估、术中精细施术、术后积极预防是手术成功的关键。
Objective： To discuss the operative indications,techniques and postoperative prevention of laparoscopic and choledochoscopic gallbladder-preserving cholelithotomy in abdominal cavity. Methods： The clinical data of 15 patients who underwent miniinvasive gallbladder-preserving cholelithotomy from Nov. 2013 to May 2014 were retrospectively analyzed. Results： Serious cholecystitis was found in one patient during the operation,conversion to laparoscopic cholecystectomy was performed; one patient who suffered from serious adhesion with surrounding tissue of gallbladder was converted to open cholecystectomy; other 13 cases of gallbladder-preserving cholelithotomy were successful,and no obvious complications occurred after the operation. Operative time was（ 74. 3 ± 34. 7） min（ range,30-150 min）. Hemorrhage during the operation was（ 9. 8 ± 2. 9） ml（ range,5-15 ml）. The ambulation was on the postoperative second day,liquid diet was used after 24 h. Hospital stay was（ 4. 8 ± 0. 8） d（ range,4-6 d）. B-mode ultrasonography was re-examined in 1-2 months after operation,no residual calculi were found. 13 patients were followed up for 6-12 months without relapse,function of gallbladder was positive. Conclusions： The mini-invasive and physiological superiority of laparoscopic and choledochoscopic gallbladderpreserving cholelithotomy in abdominal cavity is obvious. Comprehensive evaluation before the operation,careful operation,positive prevention after the operation are the keys of operation success.
出处
《腹腔镜外科杂志》
2015年第3期219-222,共4页
Journal of Laparoscopic Surgery
关键词
胆囊结石病
保胆取石术
腹腔镜检查
胆道镜检查
Cholecystolithiasis
Gallbladder-preserving cholelithotomy
Laparoscopy
Choledochoscopy
