Salm R, Waninger J, Matern U, Farthmann E H
Abteilung Allgemeine Chirurgie mit Poliklinik, Universitätsklinikum Freiburg.
Chirurg. 1994 May;65(5):418-23.
Several methods for therapy of common bile duct stones (CBDS) during laparoscopic cholecystectomy are available. After intraoperative cholangiography laparoscopic removal of CBDS can be achieved via the cystic duct or a choledochotomy using a thin cholangioscope, balloon catheters and Dormia baskets. Lithotripsy (electrohydraulic or laser) is necessary in presence of larger stones. Also combined procedures with intraoperative antegrade or retrograde papillotomy have been described. Published studies show that laparoscopic common bile duct exploration can be performed successfully by experienced surgeons. However, these procedures are demanding and time-consuming. Further evaluation is essential.
在腹腔镜胆囊切除术期间,有几种治疗胆总管结石(CBDS)的方法可供选择。术中胆管造影后,可通过胆囊管或使用细胆管镜、球囊导管和多尔米亚篮进行胆总管切开术,在腹腔镜下切除胆总管结石。对于较大的结石,需要进行碎石术(电液压或激光)。也有关于术中顺行或逆行乳头切开术的联合手术的描述。已发表的研究表明,经验丰富的外科医生可以成功地进行腹腔镜胆总管探查术。然而,这些手术要求高且耗时。进一步评估至关重要。