中国现代手术学杂志2025，Vol.29Issue(6)：493-500,8.DOI:10.16260/j.cnki.1009-2188.2025.06.010
腹腔镜下胆总管探查取石联合胆管一期闭合的应用研究进展
Advances in laparoscopic common bile duct exploration with primary closure
摘要
Abstract
Choledocholithiasis is a relatively common disease of the digestive system,often secondary to gallbladder stones,but also can be primarily formed in the common bile duct due to infection or bile stasis,causing severe complications such as cholangitis and biliary pancreatitis.With the development of minimally invasive surgical techniques,the treatment of choledocholithiasis has evolved from traditional open surgery to laparoscopic common bile duct exploration(LCBDE),and has transitioned from the conventional practice of T-tube drainage towards minimally invasive strategies and enhanced recovery after surgery.LCBDE with primary duct closure avoids T-tube-related complications and preserves the Oddi sphincter function,emerging as the preferred clinical strategy.Currently,three main procedures,including laparoscopic transcystic common bile duct exploration(LTCBDE),laparoscopic choledochotomy for common bile duct exploration(LCCBDE),and laparoscopic transcystic approach with micro-incision of the cystic duct confluence in common bile duct exploration(LTM-CBDE)are adopted,each possessing its own features and range of indications.Innovations in surgical techniques and instrumentation,including the application of 3D laparoscopy,indocyanine green fluorescence imaging,and laser lithotripsy,have enhanced the precision and safety of the treatment of choledocholithiasis.While each technique has its merits and limitations,LCBDE with primary closure,when guided by a multidisciplinary team-work(MDT)for personalized patient management,represents a promising direction for improving patient prognosis and quality of life.This article reviews the main surgical approaches and their characteristics in LCBDE.关键词
胆总管结石/腹腔镜胆总管探查术/胆道镜/胆管取石/一期闭合Key words
choledocholithiasis/laparoscopic common bile duct exploration/choledochoscope/bile duct stone removal/primary closure引用本文复制引用
龚科,王思远,刘宁..腹腔镜下胆总管探查取石联合胆管一期闭合的应用研究进展[J].中国现代手术学杂志,2025,29(6):493-500,8.基金项目
孝感市自然科学计划项目(XGKJ2024010003) （XGKJ2024010003）
普通外科国家级临床重点建设专科院级课题项目(XGZX202402) （XGZX202402）
