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腹腔镜肝切除术联合内镜乳头球囊扩张术治疗复杂胆管结石

Laparoscopic hepatectomy combined with endoscopic papillary balloon dilation for complex bile duct stones.

作者信息

Yang Jian, Zhang Fabiao, Du Xuefeng, Wang Aidong, Lv Shangdong, Fang Zheping

机构信息

Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Taizhou, China.

出版信息

ANZ J Surg. 2018 Jun;88(6):E522-E525. doi: 10.1111/ans.14132. Epub 2017 Aug 13.

Abstract

BACKGROUND

We evaluated the feasibility and efficacy of laparoscopic hepatectomy (LH) combined with endoscopic papillary balloon dilation (EPBD) for removing intra- and extrahepatic bile duct stones.

METHODS

A total of 26 patients with intra- and extrahepatic bile duct stones underwent LH and EPBD. Selective hemi-hepatic vascular occlusion was used to complete the LH. EPBD was performed under the guidance of a guidewire, and stones were removed with a stone basket or balloon.

RESULTS

A one-stage LH with EPBD lithotomy was successfully performed in 26 cases. No residual bile duct stones, intestinal or bile duct perforations were found. In addition, no severe post-operative bleeding, severe pancreatitis or mortality occurred. Post-operative hyperamylasemia was observed in five cases and bile leakage in one case. Post-operative hospital stays lasted 7-11 days.

CONCLUSION

LH combined with EPBD applied to intra- and extrahepatic bile duct stones was feasible, effective and safe, resulting in rapid recovery and few post-operative complications.

摘要

背景

我们评估了腹腔镜肝切除术(LH)联合内镜乳头球囊扩张术(EPBD)治疗肝内和肝外胆管结石的可行性和疗效。

方法

共有26例肝内和肝外胆管结石患者接受了LH和EPBD治疗。采用选择性半肝血管阻断完成LH。在导丝引导下进行EPBD,并用取石篮或球囊取出结石。

结果

26例患者成功实施了一期LH联合EPBD取石术。未发现残留胆管结石、肠道或胆管穿孔。此外,未发生严重术后出血、严重胰腺炎或死亡。5例患者术后出现高淀粉酶血症,1例出现胆漏。术后住院时间为7 - 11天。

结论

LH联合EPBD应用于肝内和肝外胆管结石可行、有效且安全,能实现快速康复且术后并发症少。

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