Arnaud J P, Tuech J J, Person B, Casa C, Leroux C, Boyer J
C.H.U. Angers, Service de Chirurgie Viscérale.
Chirurgie. 1997;122(5-6):329-32.
The aim of this study was to assess retrograd cholangiogram findings and first-line endoscopic sphincterotomy followed by laparoscopic cholecystectomy for the treatment of main bile duct lithiasis. Clinical, biological and echographic criteria predictive of main bile duct lithiasis were observed in 125 patients (32 men, 93 women, mean age 44.2 years) who underwent retrograde cholangiography. Results suggested lithiasis of the main bile duct in 105 case (87.5%) and were confirmed at endoscopic sphincterotomy in 99. There were no deaths; four complications occurred (3 moderate cases of pancreatitis, 1 cholecystitis). Conversion was required in 11.6%, usually because of difficulties in dissecting. No residual lithiasis was observed. Mean duration of hospitalization was 11.4 days. This sequential treatment scheme for main bile duct lithiasis appears to be effective, minimally invasive and safe.
本研究的目的是评估逆行胆管造影结果以及一线内镜括约肌切开术联合腹腔镜胆囊切除术治疗主胆管结石的效果。对125例行逆行胆管造影的患者（32例男性，93例女性，平均年龄44.2岁）观察了预测主胆管结石的临床、生物学和超声标准。结果提示105例（87.5%）存在主胆管结石，99例经内镜括约肌切开术得到证实。无死亡病例；发生4例并发症（3例中度胰腺炎、1例胆囊炎）。11.6%的患者需要中转手术，通常是因为解剖困难。未观察到残留结石。平均住院时间为11.4天。这种主胆管结石的序贯治疗方案似乎有效、微创且安全。
