Sharma A, Sullivan M, English H, Foley R
Department of Surgery, Bedford Hospital, England.
Surg Laparosc Endosc. 1994 Dec;4(6):433-5.
Since the first laparoscopic cholecystectomy in 1987 by Mouret, the scope of biliary surgery available to a laparoscopic surgeon has increased. In the early days of the procedure there were several accepted contraindications. Some of these were acute cholecystitis, morbid obesity, adherent gallbladder, jaundiced patients, ductal calculi, and biliary tract anomalies. In a series of 300 laparoscopic cholecystectomies we encountered five cholecystoduodenal fistulae. It was possible to deal with four fistulae laparoscopically. Two patients underwent a laparotomy, one for a failed laparoscopic repair of cholecystoduodenal fistula and the other for several common bile duct (CBD) stones, which could not be removed laparoscopically via the cystic duct. We maintain that with increasing expertise and improved instrumentation, most cases of cholecystoduodenal fistula could be dealt with laparoscopically.
自1987年穆雷首次进行腹腔镜胆囊切除术以来，腹腔镜外科医生可开展的胆道手术范围有所扩大。在该手术开展初期，存在一些公认的禁忌症。其中包括急性胆囊炎、病态肥胖、胆囊粘连、黄疸患者、胆管结石和胆道畸形。在一系列300例腹腔镜胆囊切除术中，我们遇到了5例胆囊十二指肠瘘。其中4例瘘管可以通过腹腔镜处理。两名患者接受了剖腹手术，一名是因为腹腔镜修复胆囊十二指肠瘘失败，另一名是因为有几块胆总管结石，无法通过胆囊管经腹腔镜取出。我们认为，随着专业技术的提高和器械的改进，大多数胆囊十二指肠瘘病例都可以通过腹腔镜处理。
