Sarli L, Sabadini G, Pietra N, Longinotti E, Carreras F, Peracchia A
General Surgical Clinic, Parma University, Italy.
Surg Laparosc Endosc. 1995 Feb;5(1):68-71.
Several options have been described for the management of unsuspected common bile duct stones diagnosed for the first time by transcystic cholangiography during laparoscopic surgery. These include immediate conversion to open laparotomy and formal common bile duct exploration, laparoscopic bile duct exploration, or postoperative biliary endoscopy (i.e., ERCP with sphincterotomy and stone extraction). Herein we describe a fourth option which allows the surgeon to manage both cholelithiasis and choledocholithiasis at the time of laparoscopic intervention: endoscopic sphincterotomy performed immediately after laparoscopic cholecystectomy under one anesthetic. This option seems the most logical when the surgeon wishes to preserve the minimally invasive approach.
对于在腹腔镜手术期间经胆囊胆管造影首次诊断出的意外胆总管结石的处理，已有多种方案被描述。这些方案包括立即转为开腹剖腹术并进行正规的胆总管探查、腹腔镜胆管探查或术后胆道内镜检查（即内镜逆行胰胆管造影术加括约肌切开术及取石术）。在此我们描述第四种方案，该方案可让外科医生在腹腔镜手术时同时处理胆结石和胆总管结石：在一次麻醉下于腹腔镜胆囊切除术后立即进行内镜括约肌切开术。当外科医生希望保留微创入路时，此方案似乎最为合理。
