腹腔镜与内镜治疗肝外胆管结石（附87例报道）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 钟先荣 ¹ , 修典荣 ² , 覃怀成 ¹ , 梁三海 ¹

1. ;
2. ;

Corresponding author：

钟先荣, Email: maoyou200520197@163.com

Keywords：

腹腔镜手术; 内镜; 肝外胆管结石

DOI：

10.7507/1007-9424.20150063

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的探讨腹腔镜与内镜两种不同方法在肝外胆管结石治疗中的临床应用价值。方法回顾性分析2008年7月至2014年8月期间收治的87例单纯肝外胆管结石患者的临床资料。结果 2组在术后肠功能恢复时间及取石成功率比较差异无统计学意义（P＞0.05）。内镜组的手术时间、住院时间及术中出血均明显少于腹腔镜组（P＜0.05）。随访2个月～6年（平均3.5年），腹腔镜和内镜组各有4例胆道感染和2例胰腺炎。另外，腹腔镜组2例结石复发；内镜组有1例结石复发，1例胆管出血，1例胆管狭窄。2组并发症发生率比较，差异无统计学意义（P＞0.05）。结论肝外胆管结石较大、较多时适合应用腹腔镜治疗，胆管未扩张的较小结石或有上腹手术史的结石则应用内镜治疗较合理。内镜在肝外胆管结石治疗中较腹腔镜显示出更大微创优势。

Citation： 钟先荣, 修典荣, 覃怀成, 梁三海. 腹腔镜与内镜治疗肝外胆管结石（附87例报道）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(2): 238-240. doi: 10.7507/1007-9424.20150063 Copy

1.	钟先荣.肝外胆道系统结石微创治疗的研究进展.腹腔镜外科杂志, 2014, 19(2): 150-153.
2.	Varban O, Assimos D, Passman C, et al. Laparoscopic common bile duct exploration and holmium laser lithotripsy: a novel approach to the management of common bile duct stones. Surg Endosc, 2010, 24(7): 1759-1764.
3.	钟先荣, 孔勇, 卢榜裕, 等.输尿管镜联合腹腔镜在肝外胆管结石治疗中的应用.中国微创外科杂志, 2010, 10(1): 82-83.
4.	石玉宝, 康金旺, 鲁蓓, 等.胆囊合并肝外胆管结石的微创治疗探讨.中国内镜杂志, 2011, 17(11): 1193-1195, 1200.
5.	钟先荣.肝胆管结石的微创治疗.实用医学杂志, 2010, 26(12): 2085-2087.
6.	Rivas H, Varela E, Scott D. Single-incision laparoscopic cholecys-tectomy: initial evaluation of a large series of patients. Surg Endosc, 2009, 29(5): 78-79.
7.	Schlager A, Khalaileh A, Shussman N, et al. Providing more through less: current methods of retraction in SIMIS and NOTES cholecystectomy. Surg Endosc, 2010, 24(7): 1542-1546.
8.	黄博, 侯波.腹腔镜联合十二指肠镜一期治疗胆囊结石合并胆总管结石.中国微创外科杂志, 2012, 12(4): 301-302.
9.	Bark K, Gamblin TC, Zuckerman R, et al. Operative choledochos-copic laser lithotripsy for impacted intrahepatic gallstones: a novel surgical approach. Surg Endosc, 2009, 23(1): 221-224.
10.	陈德忠, 詹志林, 陈云, 等.腹腔镜联合胆道镜治疗肝外胆管结石36例临床体会.肝胆外科杂志, 2011, 19(5): 361-363.
11.	汪家航, 林明强, 林贤平.不同术式对胆结石患者的临床影响.四川解剖学杂志, 2013, 21(3): 20-22.
12.	Decker G, Borie F, Millat B, et al. One hundred laparoscopic choledochotomies with primary closure of the common bile duct. Surg Endosc, 2003, 17(1): 12-18.

1. 钟先荣.肝外胆道系统结石微创治疗的研究进展.腹腔镜外科杂志, 2014, 19(2): 150-153.
2. Varban O, Assimos D, Passman C, et al. Laparoscopic common bile duct exploration and holmium laser lithotripsy: a novel approach to the management of common bile duct stones. Surg Endosc, 2010, 24(7): 1759-1764.
3. 钟先荣, 孔勇, 卢榜裕, 等.输尿管镜联合腹腔镜在肝外胆管结石治疗中的应用.中国微创外科杂志, 2010, 10(1): 82-83.
4. 石玉宝, 康金旺, 鲁蓓, 等.胆囊合并肝外胆管结石的微创治疗探讨.中国内镜杂志, 2011, 17(11): 1193-1195, 1200.
5. 钟先荣.肝胆管结石的微创治疗.实用医学杂志, 2010, 26(12): 2085-2087.
6. Rivas H, Varela E, Scott D. Single-incision laparoscopic cholecys-tectomy: initial evaluation of a large series of patients. Surg Endosc, 2009, 29(5): 78-79.
7. Schlager A, Khalaileh A, Shussman N, et al. Providing more through less: current methods of retraction in SIMIS and NOTES cholecystectomy. Surg Endosc, 2010, 24(7): 1542-1546.
8. 黄博, 侯波.腹腔镜联合十二指肠镜一期治疗胆囊结石合并胆总管结石.中国微创外科杂志, 2012, 12(4): 301-302.
9. Bark K, Gamblin TC, Zuckerman R, et al. Operative choledochos-copic laser lithotripsy for impacted intrahepatic gallstones: a novel surgical approach. Surg Endosc, 2009, 23(1): 221-224.
10. 陈德忠, 詹志林, 陈云, 等.腹腔镜联合胆道镜治疗肝外胆管结石36例临床体会.肝胆外科杂志, 2011, 19(5): 361-363.
11. 汪家航, 林明强, 林贤平.不同术式对胆结石患者的临床影响.四川解剖学杂志, 2013, 21(3): 20-22.
12. Decker G, Borie F, Millat B, et al. One hundred laparoscopic choledochotomies with primary closure of the common bile duct. Surg Endosc, 2003, 17(1): 12-18.

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腹腔镜与内镜治疗肝外胆管结石（附87例报道）

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