腹腔鏡與內鏡治療肝外膽管結石（附87例報道）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 鐘先榮 ¹ , 修典榮 ² , 覃懷成 ¹ , 梁三海 ¹

1. ;
2. ;

Corresponding?author：

鐘先榮, Email: maoyou200520197@163.com

Keywords：

腹腔鏡手術; 內鏡; 肝外膽管結石

DOI：

10.7507/1007-9424.20150063

Video：

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目的探討腹腔鏡與內鏡兩種不同方法在肝外膽管結石治療中的臨床應用價值。方法回顧性分析2008年7月至2014年8月期間收治的87例單純肝外膽管結石患者的臨床資料。結果 2組在術后腸功能恢復時間及取石成功率比較差異無統計學意義（P＞0.05）。內鏡組的手術時間、住院時間及術中出血均明顯少于腹腔鏡組（P＜0.05）。隨訪2個月～6年（平均3.5年），腹腔鏡和內鏡組各有4例膽道感染和2例胰腺炎。另外，腹腔鏡組2例結石復發；內鏡組有1例結石復發，1例膽管出血，1例膽管狹窄。2組并發癥發生率比較，差異無統計學意義（P＞0.05）。結論肝外膽管結石較大、較多時適合應用腹腔鏡治療，膽管未擴張的較小結石或有上腹手術史的結石則應用內鏡治療較合理。內鏡在肝外膽管結石治療中較腹腔鏡顯示出更大微創優勢。

Citation： 鐘先榮, 修典榮, 覃懷成, 梁三海. 腹腔鏡與內鏡治療肝外膽管結石（附87例報道）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(2): 238-240. doi: 10.7507/1007-9424.20150063 Copy

1.	?鐘先榮.肝外膽道系統結石微創治療的研究進展.腹腔鏡外科雜志, 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.	鐘先榮, 孔勇, 盧榜裕, 等.輸尿管鏡聯合腹腔鏡在肝外膽管結石治療中的應用.中國微創外科雜志, 2010, 10(1): 82-83.
4.	石玉寶, 康金旺, 魯蓓, 等.膽囊合并肝外膽管結石的微創治療探討.中國內鏡雜志, 2011, 17(11): 1193-1195, 1200.
5.	鐘先榮.肝膽管結石的微創治療.實用醫學雜志, 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.	黃博, 侯波.腹腔鏡聯合十二指腸鏡一期治療膽囊結石合并膽總管結石.中國微創外科雜志, 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.	陳德忠, 詹志林, 陳云, 等.腹腔鏡聯合膽道鏡治療肝外膽管結石36例臨床體會.肝膽外科雜志, 2011, 19(5): 361-363.
11.	汪家航, 林明強, 林賢平.不同術式對膽結石患者的臨床影響.四川解剖學雜志, 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. ?鐘先榮.肝外膽道系統結石微創治療的研究進展.腹腔鏡外科雜志, 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. 鐘先榮, 孔勇, 盧榜裕, 等.輸尿管鏡聯合腹腔鏡在肝外膽管結石治療中的應用.中國微創外科雜志, 2010, 10(1): 82-83.
4. 石玉寶, 康金旺, 魯蓓, 等.膽囊合并肝外膽管結石的微創治療探討.中國內鏡雜志, 2011, 17(11): 1193-1195, 1200.
5. 鐘先榮.肝膽管結石的微創治療.實用醫學雜志, 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. 黃博, 侯波.腹腔鏡聯合十二指腸鏡一期治療膽囊結石合并膽總管結石.中國微創外科雜志, 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. 陳德忠, 詹志林, 陳云, 等.腹腔鏡聯合膽道鏡治療肝外膽管結石36例臨床體會.肝膽外科雜志, 2011, 19(5): 361-363.
11. 汪家航, 林明強, 林賢平.不同術式對膽結石患者的臨床影響.四川解剖學雜志, 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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腹腔鏡與內鏡治療肝外膽管結石（附87例報道）

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