临床肝胆病杂志2018，Vol.34Issue(3)：521-525,5.DOI:10.3969/j.issn.1001-5256.2018.03.014
鼻胆囊引流管辅助下行腹腔镜胆囊次全切除术的临床体会
A clinical study of endoscopic naso-gallbladder drainage-assisted laparoscopic subtotal cholecystectomy
李广阔 1杨红 1王洪波 1廖伟 1兰燕 1周洁 1周晶晶 1陈俊 2李鑫3
作者信息
- 1. 重庆市中医院南桥寺院部普通外科,重庆400021
- 2. 武警重庆市总队医院肝胆外科,重庆400061
- 3. 成都中医药大学附属医院普通外科,成都610072
- 折叠
摘要
Abstract
Objective To summarize our experience in endoscopic naso-gallbladder drainage(ENGBD)-assisted laparoscopic subtotal cholecystectomy(LSC)in patients with chronic atrophic cholecystitis. Methods A retrospective analysis was performed for the clinical data of 124 patients with chronic atrophic cholecystitis complicated by secondary common bile duct stones who were admitted to Department of Hepatobiliary Surgery in Chongqing Hospital of Armed Police Force,Department of General Surgery in The Affiliated Hospital of Chengdu U-niversity of Traditional Chinese Medicine,and Department of General Surgery in Chongqing Traditional Chinese Medicine Hospital from Jan-uary 2007 to December 2016. All patients underwent endoscopic retrograde cholangiopancreatography(ERCP),sphincterotomy,and lithot-omy. The patients undergoing ENGBD were enrolled as experimental group(group A with 47 patients),and those undergoing endoscopic nasobiliary drainage(ENBD)were enrolled as control group(group B with 77 patients). All patients were treated with laparoscopic chole-cystectomy(LC)or LSC after ERCP,and the patients in difficult conditions were converted to open cholecystectomy(OC). The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups. Results Compared with group B,group A had a significantly higher success rate of LSC(53.2% vs 20.8%)and a significantly lower pro-portion of patients undergoing OC(4.3% vs 35.1%). Due to the complicated conditions such as internal fistula between the gallbladder and adjacent organs(including Mirizzi syndrome),unsuspected gallbladder carcinoma,and cystic duct abnormalities,group B had a great difficulty in the placement of ENGBD,which led to injuries in the hepatic artery/vein,and some patients were converted to open surgery due to concerns of bile duct injury. Conclusion In patients with chronic atrophic cholecystitis with secondary choledocholithiasis,ENGBD after ERCP helps with the successful performance of LSC and can effectively reduce the proportion of conversion to laparotomy.关键词
胆囊炎/腹腔镜,胆囊切除术/引流术Key words
cholecystitis/cholecystectomy,laparoscopic/drainage分类
医药卫生引用本文复制引用
李广阔,杨红,王洪波,廖伟,兰燕,周洁,周晶晶,陈俊,李鑫..鼻胆囊引流管辅助下行腹腔镜胆囊次全切除术的临床体会[J].临床肝胆病杂志,2018,34(3):521-525,5.
