Petelin J B
University of Kansas School of Medicine, Department of Surgery, Kansas City.
Endosc Surg Allied Technol. 1993 Jun;1(3):125-9.
Laparoscopic common bile duct exploration has been successfully performed in hundreds of patients throughout the world since early 1990. The author reviews his personal experience with this procedure and compares it with the experience of others as reported in the literature. A variety of methods of managing common duct pathology has been employed. These include balloon-catheter manipulation, fluoroscopically-guided basket extraction, and choledochoscopy. The relative contributions of each of these modalities to the total framework of laparoscopic treatment of common bile duct stones is presented. By these techniques, 83 out of 86 patients had their common duct explored successfully. The author concludes that, based on accumulated experience, most, if not all, common duct stones can be treated and/or removed laparoscopically. In more than 90% of the cases, this can be accomplished through a cystic duct approach, although direct access to the common duct via choledochotomy is also possible. A rational protocol for management of common duct pathology is presented.
自20世纪90年代初以来，全世界已有数百名患者成功接受了腹腔镜胆总管探查术。作者回顾了自己在该手术中的个人经验，并将其与文献中报道的其他人的经验进行了比较。已经采用了多种处理胆总管病变的方法。这些方法包括球囊导管操作、荧光镜引导下的篮式取石以及胆管镜检查。介绍了这些方法在腹腔镜治疗胆总管结石的整体框架中各自的相对作用。通过这些技术，86例患者中有83例成功进行了胆总管探查。作者得出结论，基于积累的经验，大多数（如果不是全部）胆总管结石可以通过腹腔镜进行治疗和/或取出。在超过90%的病例中，这可以通过胆囊管途径完成，尽管通过胆总管切开术直接进入胆总管也是可行的。本文还提出了一个合理的胆总管病变处理方案。
