胆总管结石的管理：一家三级医疗中心的十年经验
Management of common bile duct stones: a ten-year experience at a tertiary care center.
作者信息
Lacitignola Sebastiano, Minardi Martino
机构信息
General Surgery Department, Martina Franca Hospital, Taranto, Italy.
出版信息
JSLS. 2008 Jan-Mar;12(1):62-5.
BACKGROUND
The authors present their experience with the treatment of cholecystocholedocholithiasis.
METHODS
From August 1995 to August 2005, we treated 3750 patients with symptomatic gallbladder stones, and 12.7% of these patients also had a choledocholithiasis. This percentage with reference to the literature is certainly due to intraoperative cholangiography (IOC) performed routinely. During the follow-up, the percentage of residual versus recurrent stones was evaluated.
RESULTS
Only 2 patients (3.1%) of the laparoscopic choledochotomy and cholecystectomy group had retained stones discovered at 5 and 11 months after surgery. These patients received ERCP with good results. No patients had leaks or fistulas. Only one patient died from a massive pulmonary embolism (1.6%).
CONCLUSION
We believe that the key to successful management of patients with CBD stones is a well-standardized institutional procedural algorithm consistent with the available local resources and technologies.
背景
作者介绍了他们治疗胆囊胆总管结石的经验。
方法
1995年8月至2005年8月，我们治疗了3750例有症状胆囊结石患者，其中12.7%的患者同时患有胆总管结石。与文献相比，这一比例的确得益于常规进行的术中胆管造影（IOC）。随访期间，评估了残留结石与复发结石的比例。
结果
腹腔镜胆总管切开术和胆囊切除术组中，仅2例患者（3.1%）在术后5个月和11个月发现有残留结石。这些患者接受了内镜逆行胰胆管造影（ERCP），效果良好。无患者出现渗漏或瘘管。仅1例患者死于大面积肺栓塞（1.6%）。
结论
我们认为，成功治疗胆总管结石患者的关键是制定一个符合当地可用资源和技术的标准化机构手术流程。
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