双镜联合不同入路治疗老年人肝外胆管结石的比较
Comparative Analysis of Different Route of Laparoscopy with Choledochoscopy and Laparoscopy with Duodenoscopy in the Treatment of Cholelithiasis Complicated by Choledocholithiasis in Elderly Patients
作者: 李新丰 * , 李祖金 , 王高雄 , 王艳军 :福建医科大学附属第二医院肝胆胰外科,福建 泉州;
关键词: 腹腔镜; 胆道镜; 十二指肠镜; 胆囊结石; 胆总管结石; Laparoscopy; Choledochoscopy; Duodenoscopy; Cholelithiasis; Choledocholithiasis
摘要:Abstract: Objective: To study the efficacy of Endoscopic Sphincterotomy (EST) and Laparoscopic Cholecys-tectomy (LC) in the treatment of elderly patients with cholelithiasis and choledocholithiasis. Me-thod: Retrospective analysis of 42 elderly patients with cholecystolithiasis and choledocholithiasis which were treated by EST and LC (scheme A), and 42 cases were analysed in same period of laparoscopy combined with choledochoscopy (scheme B) in the treatment of cholelithiasis complicated by choledocholithiasis in elderly patients in our hospital. Result: Success rate of the two schemes was 100%. No other serious complications were happened. Scheme A was better than scheme B in the bowel moved recovery and hospitalization (22.3 ± 5.7 vs 57.7 ± 8.6; 8.75 ± 3.17 vs 13.16 ± 2.38; P < 0.01). Conclusion: EST joint LC and laparoscopy combined with choledochoscopy are a minimally invasive operation for elderly patients with cholelithiasis and choledocholithiasis, and it is safe, effective, feasible, but scheme A shows good clinical results than scheme B.
文章引用: 李新丰 , 李祖金 , 王高雄 , 王艳军 (2016) 双镜联合不同入路治疗老年人肝外胆管结石的比较。 外科, 5, 21-24. doi: 10.12677/HJS.2016.52003
参考文献
[1] 李新丰, 王高雄, 黄天从, 等. 腹腔镜联合胆道镜体内碎石治疗老年人肝外胆道结石[J]. 中华诊断学杂志, 2015, 3(3): 221.
[2] Mangla, V., Chander, J., Vindal, A., et al. (2012) A Randomized Trim Eomparing the Use of Endobiliary Stent and T-Tube for Biliary Decompression Alter Laparoseopie Common Bile Duct Exploration. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 22, 345-348. http://dx.doi.org/10.1097/SLE.0b013e31825b297d
[3] 叶小勇, 吕会增, 张帆. 腹腔镜胆总管探查术治疗复杂性肝胆管结石疗效分析[J]. 中国普通外科杂志, 2014, 23(2): 256-258.
[4] 朱绍辉, 李荣, 王建国, 等. 腹腔镜联合胆道镜治疗胆囊胆总管结石[J]. 中华腔镜外科杂志(电子版), 2010, 3(1): 87-91.
[5] Pesce, A., Potale, T.R., Minutolo, V., et al. (2012) Bile Duct Injury during Laparo-Seopie Cholecystectomy without Intraoperative Eholangiography: A Retrospective Study on 1,100 Selected Patients. Digestive Surgery, 29, 310-314. http://dx.doi.org/10.1159/000341660
[6] 郑光威, 张寰, 冯秋实. 腹腔镜胆总管探查术后胆管一期缝合的临床应用分析[J]. 中国内镜杂志, 2011, 17(8): 798-801.
[7] 李玉民, 焦作义, 李汛, 等. 微创时代三镜联合治疗困难肝外胆管结石[J]. 中华腔镜外科杂志(电子版), 2011, 4(4): 254-255.