EST联合LC治疗胆囊结石胆总管结石.pdf

文档介绍：:1005—6947(2009)08—0790—03胆道微创外科专题研究·EST联合LC治疗胆囊结石胆总管结石王安,黄海燕,韩鑫,刘燕(,陕西汉中723000)摘要:目的探讨EST联合LC联合治疗胆囊、胆总管结石的可行性及优越性。方法先行EST(经内镜十二指肠乳头括约肌切开术)取出胆总管结石,再行Lc(腹腔镜胆囊切除术),EST失败或不宜行EST者置ENBD(鼻胆管)再行Lc+腹腔镜下胆道探查、胆道镜取石,或开腹行胆道探查术。结果全组99例,91例LC术前EST取石成功,3例Lc术后EST取石成功,3例EST取石失败。2例年龄小于l5岁者未行EST改行Lc+腹腔镜下经胆囊管胆道镜胆道探查取石。3例EST取石失败,改行腹腔镜下胆道探查胆道镜取石、胆总管一期缝合或T管引流+Lc,或开腹胆道探查一期缝合胆总管未置T管(已置ENBD)。无严重并发症,患者均治愈出院。结论EST联合Lc联合治疗胆囊结石胆总管结石是安全、可靠的方法,软硬镜联合充分体现了“微创”治疗的优势。[中国普通外科杂志,2009,18(8):790—792】关键词:胆结石/治疗;腹腔镜;十二指肠镜;胆道镜中图分类号::monbileductstonesWANGAn,HUANGHaiyan,HANXin,LIUYah(,PeoplesHospital,o厂HanzhongCity,Hanzhong,Shaanxi723000,China)Abstract:(holecystectomy)precededbyEST(endoscopicsphincterotomy)(asalbiliarydrainagetube)wasplacedifESTfailureandthenthepatientunderwentLC+laparoscopicbiliaryductexploration(LCBDE),,essful,essfulin3cases,+,whohadESTfailureunderwentLC+monbileductorLCBDEwithT-monbileduct,monbileduct(ENBDwasinplace).