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腹腔镜与软性胆道镜时代的保胆取石术:316例报告

Gallbladder-preserving cholelithotomy in laparoscopic and flexible choledochoscopic era: a report of 316 cases.

作者信息

Zha Yong, Zhou Zheng-Zhong, Chen Xun-Ru, Gan Ping, Tan Jing

机构信息

Department of Abdominal Surgery, The Third Affiliated Hospital, Kunming Medical University, Kunming, China.

出版信息

Surg Laparosc Endosc Percutan Tech. 2013 Apr;23(2):167-70. doi: 10.1097/SLE.0b013e31828a0b5f.

Abstract

BACKGROUND

The gallbladder is an organ with accurate functions of concentrating and storing bile and regulating the bile flow. Cholecystectomy is associated with some severe complications in some patients. This study was to investigate the safety and effectiveness of gallbladder-preserving cholelithotomy (GPC) for patients with gallstones in laparoscopic and flexible choledochoscopic era.

METHODS

From January 2006 to January 2007, a total of 316 patients with gallstone were assigned to GPC according to our inclusion criteria at Yunna Lithiasis Hospital. The procedures were performed by 1 surgical team under laparoscopic and flexible choledochoscopic guidance. The short-term clinical outcome and long-term gallstone recurrence rate were evaluated.

RESULTS

The success rate of GPC was 95.25%. No severe postoperative complications such as bile leakage and hemorrhage occurred. Conversion to cholecystectomy was required in 15 patients. During 25 to 72 months of follow-up, the gallstone recurrence rate at 12, 36, and 60 months were 0%, 3.32%, and 5.64%, respectively.

CONCLUSION

GPC using laparoscopy and flexible choledochoscopy is safe and effective in selected patients, the stone recurrence rate is acceptable.

摘要

背景

胆囊是一个具有精确浓缩、储存胆汁及调节胆汁流动功能的器官。胆囊切除术在部分患者中会引发一些严重并发症。本研究旨在探讨在腹腔镜及软性胆道镜时代,保胆取石术(GPC)治疗胆结石患者的安全性及有效性。

方法

2006年1月至2007年1月,共有316例胆结石患者根据纳入标准被分配至云南结石病医院接受保胆取石术。手术由1个手术团队在腹腔镜及软性胆道镜引导下进行。对短期临床结局及长期胆结石复发率进行评估。

结果

保胆取石术成功率为95.25%。未发生胆漏、出血等严重术后并发症。15例患者中转行胆囊切除术。在25至72个月的随访期间,12个月、36个月及60个月时的胆结石复发率分别为0%、3.32%及5.64%。

结论

在选定患者中,采用腹腔镜及软性胆道镜的保胆取石术安全有效,结石复发率可接受。

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