腹腔镜下胆管再探查术治疗残留胆管结石
Laparoscopic bile duct reexploration for retained duct stones.
作者信息
Chiappetta Porras L T, Nápoli E D, Canullán C M, Quesada B M, Petracchi J E, Oría A S
机构信息
Department of Surgery, Cosme Argerich Hospital, Alte. Brown 240, Buenos Aires, Argentina.
出版信息
J Gastrointest Surg. 2008 Sep;12(9):1518-20. doi: 10.1007/s11605-008-0596-6. Epub 2008 Jul 12.
BACKGROUND
Failure of endoscopic sphincterotomy (ES) for retained bile duct stones occurs in 4% to 10% of cases and was traditionally managed with open bile duct reexploration.
METHODS
This study uses retrospective analysis of a consecutive series of cases of laparoscopic bile duct reexploration for retained bile duct stones after unsuccessful ES.
RESULTS
Thirty-one cases were operated over a 7-year period. Seventy percent had a previous open cholecystectomy. Ten cases were successfully treated with a transcystic approach and 19 with laparoscopic choledochotomy. Two patients were converted to open surgery. Morbidity was 3.22% with no mortality.
CONCLUSION
Laparoscopic bile duct reexploration can be safely performed and should be considered as an alternative to open surgery.
背景
内镜括约肌切开术（ES）治疗残留胆管结石失败的发生率为4%至10%，传统上采用开腹胆管再次探查术治疗。
方法
本研究对ES失败后腹腔镜胆管再次探查治疗残留胆管结石的一系列连续病例进行回顾性分析。
结果
在7年期间共进行了31例手术。70%的患者曾接受过开腹胆囊切除术。10例采用经胆囊途径成功治疗，19例采用腹腔镜胆总管切开术治疗。2例患者转为开腹手术。发病率为3.22%，无死亡病例。
结论
腹腔镜胆管再次探查术可安全实施，应被视为开腹手术的替代方法。
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