腹腔镜外科杂志2025，Vol.30Issue(9)：666-669,686,5.DOI:10.13499/j.cnki.fqjwkzz.2025.09.666
十二指肠镜在胆囊结石合并胆总管结石同期手术中的应用价值
The application value of duodenoscopy in the one-stage surgery for cholelithiasis combined with choledocholithiasis
摘要
Abstract
Objective:To explore the efficacy and safety of one-stage laparoscopic and duodenoscopic surgery for the treatment of cholecystolithiasis combined with choledocholithiasis,and to summarize surgical technique and experience in complication prevention and management.Methods:A retrospective analysis was performed on clinical data from 112 patients undergoing one-stage laparoscopic and duodenoscopic treatment for concurrent cholecystolithiasis and choledocholithiasis between May 2022 and May 2024.The cohort included 48 males and 64 females,with a mean age of(63±14)years.Outcomes assessed included surgical success rate,residual stone rate,operative time,intraoperative blood loss,postoperative hospital stay,and postoperative complications such as acute pancreatitis,duodenal papillary hemorrhage,intestinal perforation,biliary tract infection,and mortality.Results:The success rate of the procedure was 97.3％(109/112).Three cases were converted to common bile duct exploration with T-tube drainage.The residual stone rate was 4.5％(5/112),and all these residual stones were successfully removed by subsequent endoscopic retrograde cholangiopancreatogra-phy.The mean operative time was(95±18)min,the mean intraoperative blood loss was(20.5±7.3)mL,and the mean postoperative hospital stay was(4.8±1.6)d.The overall postoperative complication rate was 10.7％(12/112),which included 8 cases of mild pan-creatitis,1 case of micro-perforation of the duodenal wall caused by a guidewire,and 3 cases of cholangitis.All complications resolved with conservative management(antibiotic therapy),and there were no deaths.Conclusions:The one-stage laparoscopic-duodenoscopic treatment for concomitant cholecystolithiasis and choledocholithiasis is safe and effective.It aligns with the concept of minimally invasive surgery and is worthy of broader clinical application.关键词
胆囊结石病/胆总管结石病/腹腔镜检查/十二指肠镜检查/同期手术/治疗结果Key words
Cholecystolithiasis/Choledocholithiasis/Laparoscopy/Duodenoscopy/One-stage surgery/Treatment outcome分类
临床医学引用本文复制引用
胡欢欢,郭世龙,杨潇,李英峰,丛魁武,杨梁,周文富,严操..十二指肠镜在胆囊结石合并胆总管结石同期手术中的应用价值[J].腹腔镜外科杂志,2025,30(9):666-669,686,5.基金项目
湖北省潜江市公益性行业科研项目(2024GYX004) （2024GYX004）
