Phillips E H, Rosenthal R J, Carroll B J, Fallas M J
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Surg Endosc. 1994 Dec;8(12):1389-93; discussion 1393-4. doi: 10.1007/BF00187342.
One thousand seventy-one consecutive laparoscopic cholecystectomies were performed. Routine cholangiography was employed with a 99% success rate. One hundred thirty patients were found to have common duct stones (CBDS). In 48 (37%) patients they were unsuspected. One hundred eleven patients underwent attempted trans-cystic-duct extraction techniques (TCD-CBDE). One hundred three (93%) were successful. The following techniques were employed: 101--biliary endoscopy, 23--ampullary balloon dilation, 2--fluoroscopic basket retrieval. The average operative time was 136 min. The average postsurgical stay was 3.7 days. There were 19 (17%) complications--6 (5%) major. There were 4 retained stones (2 intentional) and 1 death. Patients over 65 years of age had more complications and patients with unsuspected CBDS under 65 years of age had the fewest. TCD-CBDE is a safe, effective way to extract common duct calculi. Endoscopy and basket stone retrieval was the primary technique employed.
共进行了1071例连续的腹腔镜胆囊切除术。常规胆管造影成功率为99%。发现130例患者有胆总管结石（CBDS）。其中48例（37%）术前未被怀疑。111例患者尝试经胆囊管取石技术（TCD-CBDE）。103例（93%）成功。采用了以下技术：101例——胆道内镜检查，23例——壶腹球囊扩张，2例——透视下篮式取石。平均手术时间为136分钟。术后平均住院时间为3.7天。有19例（17%）并发症——6例（5%）为严重并发症。有4例残留结石（2例为故意残留），1例死亡。65岁以上患者并发症更多，65岁以下未被怀疑有CBDS的患者并发症最少。TCD-CBDE是一种安全、有效的取出胆总管结石的方法。内镜检查和篮式取石是主要采用的技术。
