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腹腔镜保留胆囊的胆总管探查术:原发性胆总管结石的创新技术。

Laparoscopic Common Bile Duct Exploration with Gallbladder Preservation: An Innovative Technique for Primary Common Bile Duct Stones.

机构信息

Department of Hepatobiliary Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.

出版信息

J Laparoendosc Adv Surg Tech A. 2022 Sep;32(9):974-977. doi: 10.1089/lap.2021.0825. Epub 2022 Mar 3.

Abstract

Primary common bile duct (CBD) stones can be treated with laparoscopic CBD exploration (LCBDE), during which cholecystectomy is routinely performed. For patients without gallstones, we have developed a new procedure, LCBDE with gallbladder preservation. The purpose of this study was to evaluate the management of LCBDE with gallbladder preservation at our institution. Retrospective analysis the clinical data of 105 patients with primary CBD stones. Demographic data, clinical characteristics, preoperative risk factors, and postoperative complications were evaluated. All patients were divided into two groups depending on the presence of gallstones: the primary CBD stone coexistence gallstones group (Group A,  = 15) and the primary CBD stones absence gallstones group (Group B,  = 90). Complete stones clearance was achieved in all patients. There were no significant differences in postoperative complications rates and mortality between the two groups. The mean postoperative hospital stay was 3.2 days for Group A and 4.1 days for Group B ( = .03). This study found that LCBDE with gallbladder preservation can effectively and safely treat primary CBD stones without gallbladder stones.

摘要

原发性胆总管结石(CBD)可通过腹腔镜胆总管探查术(LCBDE)治疗,在此过程中常规进行胆囊切除术。对于无胆囊结石的患者,我们开发了一种新的手术方法,即保胆的 LCBDE。本研究旨在评估我院保胆 LCBDE 的治疗管理情况。

回顾性分析 105 例原发性 CBD 结石患者的临床资料。评估了人口统计学数据、临床特征、术前危险因素和术后并发症。

所有患者均根据是否存在胆囊结石分为两组

原发性 CBD 结石伴胆囊结石组(A 组,n=15)和原发性 CBD 结石无胆囊结石组(B 组,n=90)。所有患者均成功清除完全性结石。两组患者的术后并发症发生率和死亡率无显著差异。A 组的平均术后住院时间为 3.2 天,B 组为 4.1 天(P=0.03)。

本研究发现,保胆的 LCBDE 可有效、安全地治疗无胆囊结石的原发性 CBD 结石。

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