外科理论与实践2025，Vol.30Issue(4)：339-344,6.DOI:10.16139/j.1007-9610.2025.04.08
日间腹腔镜胆囊切除术中经胆囊管胆道镜探查联合汇入部微切开或球囊扩张的临床分析
Clinical analysis of laparoscopic transcystic common bile duct exploration combined confluence microdissection or balloon dilatation at the cystic duct in day surgery laparoscopic cholecystectomy
摘要
Abstract
Objective To investigate the safety and efficacy of combined confluence microdissection or balloon dilatation followed by laparoscopic transcystic common bile duct exploration(LTCBDE)in day surgery laparoscopic cholecystectomy.Methods The clinical data of 203 patients with day surgery laparoscopic cholecystectomy combined with LTCBDE from June 2021 to June 2024 in Beijing Friendship Hospital,Capital Medical University were retrospectively analyzed.They were divided into an observation group(59 cases,including 42 cases of confluent microdissection and 17 cases of balloon dilatation)and a conventional group(144 cases)according to the surgical technique used.Baseline characteristics,intraoperative exploration results,operation time,postoperative recovery and complications were compared between the two groups.Results The history of preoperative cholangitis or pancreatitis(P<0.001)was more common in the observation group.And total bilirubin level was significantly higher in the observation group than in the conventional group(P=0.035).The observation group had a longer operative time(P=0.014)and higher hospitalization costs(P=0.001),but there was no difference in intraoperative bleeding and postoperative discharge time.There were no serious postoperative complications in either group.Conclusions Under the premise of strict patient screening,day surgery LTCBDE combined with confluence microdissection or balloon dilatation can effectively solve the problem of difficult choledochoscopic access,with high safety and thoroughness of exploration.Both techniques provide a feasible minimally observation solution for day surgery biliary exploration.关键词
日间手术/胆道镜/经胆囊管/汇合部微切开/球囊扩张Key words
Day surgery/Choledochoscopy/Transcystic duct/Confluence microdissection/Balloon dilatation分类
医药卫生引用本文复制引用
吴鸿伟,佟奎南,李浩楠,汪栋,刘坤,郭伟..日间腹腔镜胆囊切除术中经胆囊管胆道镜探查联合汇入部微切开或球囊扩张的临床分析[J].外科理论与实践,2025,30(4):339-344,6.基金项目
国家卫生健康委员会医药卫生科技发展研究中心项目(WKZX2023YG0108) （WKZX2023YG0108）
