Waage A, Strömberg C, Leijonmarck C-E, Arvidsson D
Department of Surgery, Karolinska Hospital, S-17176 Stockholm, Sweden.
Surg Endosc. 2003 Aug;17(8):1181-5. doi: 10.1007/s00464-002-8937-0. Epub 2003 May 13.
The aim of this study was to evaluate the long-term results after laparoscopic common bile duct exploration (LCBDE).
A retrospective review of 175 consecutive patients who underwent attempted LCBDE between 1992 and 1999 was conducted. Laparoscopic transcystic exploration was accomplished in 110 patients and laparoscopic choledochotomy in 52 patients. Conversion to an open common bile duct exploration was required for 13 patients (7.4%). Retained common bile duct stones occurred in eight patients (4.6%). The 30-day postoperative morbidity was 6.9%, and there was no 30-day mortality. All the patients (alive and localized) received a questionnaire evaluating long-term results.
Of the 175 patients, 169 (4 unrelated deaths and 2 patients lost to follow-up evaluation) received and 152 (90%) returned the questionnaire. The follow-up period ranged from 6 to 72 months (median, 36 months). One patient developed recurrent common bile duct stones. There were no signs or evidence of common bile duct stricture in any patient.
The LCBDE procedure can be performed without increased risk of late bile duct complications.
本研究的目的是评估腹腔镜胆总管探查术(LCBDE)后的长期结果。
对1992年至1999年间连续175例行LCBDE尝试的患者进行回顾性研究。110例患者采用腹腔镜经胆囊管探查术,52例患者采用腹腔镜胆总管切开术。13例患者(7.4%)需要转为开腹胆总管探查术。8例患者(4.6%)出现残留胆总管结石。术后30天发病率为6.9%,无30天死亡率。所有患者(存活且定位明确)均收到一份评估长期结果的问卷。
175例患者中,169例(4例非相关死亡和2例失访)收到问卷,152例(90%)回复了问卷。随访时间为6至72个月(中位数为36个月)。1例患者出现复发性胆总管结石。所有患者均无胆总管狭窄的体征或证据。
LCBDE手术不会增加晚期胆管并发症的风险。