Rhodes M, Nathanson L
Department of Surgery, University of Queensland, Brisbane, Australia.
Surg Laparosc Endosc. 1996 Aug;6(4):318-21.
Choledochoduodenostomy is less often performed since the advent of ERCP and endoscopic sphincterotomy (ES). It may, however, still prove necessary in patients where ERCP and ES fail to provide long-term biliary drainage or when CBD stones recur after ES. We have performed laparoscopic choledochoduodenostomy in two patients (aged 66 and 71 years). Surgery was performed in one patient for recurrent CBD stones 25 years after cholecystectomy where three attempts at ERCP failed to cannulate the CBD. In the second patient it was performed for recurrent CBD stones 16 years after cholecystectomy and after two previous endoscopic sphincterotomies. Surgery was completed in just over 3 h in both cases and postoperative stay was 4 days. Laparoscopic choledochoduodenostomy is a viable technique which may prove valuable in the management of patients in whom ERCP and ES has failed to provide long-term biliary drainage.
自从内镜逆行胰胆管造影术（ERCP）和内镜括约肌切开术（ES）出现以来，胆总管十二指肠吻合术的实施频率降低。然而，对于ERCP和ES无法提供长期胆汁引流的患者，或者ES术后胆总管结石复发的患者，该手术可能仍有必要。我们为两名患者（分别为66岁和71岁）实施了腹腔镜胆总管十二指肠吻合术。其中一名患者在胆囊切除术后25年因复发性胆总管结石接受手术，此前三次ERCP尝试均未能成功插管至胆总管。另一名患者在胆囊切除术后16年，且之前接受过两次内镜括约肌切开术后，因复发性胆总管结石接受该手术。两例手术均在3小时多一点的时间内完成，术后住院时间为4天。腹腔镜胆总管十二指肠吻合术是一种可行的技术，对于ERCP和ES未能提供长期胆汁引流的患者管理可能具有重要价值。
