择期腹腔镜胆囊切除术中胆囊管结石29例报

择期腹腔镜胆囊切除术中胆囊管结石29例报告

奚春华孙跃明傅赞张川

（南京医院普外科，南京）

目的：探讨择期腹腔镜胆囊切除术中胆囊管结石（cysticductlithiasis,CDL）的发生率及处理方法。方法：回顾性分析我科年6月~年12月例择期LC中29例CDL的临床资料，对CDL的临床表现、诊断方法、处理方式进行分析。结果：隐匿性胆囊管结石16例，梗阻性胆囊管结石12例，Mirizzi综合征1例；所有结石均取出。存在胆总答结石8例（27.6%）。29例术后随访平均10个月（6~20个月），无胆道狭窄和结石残留等并发症。结论：CDL在胆囊结石患者中并不少见，术前诊断困难，隐匿性结石比率高。腹腔镜胆囊切除术中应掌握正确的处理办法，对胆囊管全程游离和系统探查，从根部离断胆囊管，以免术后CDL残留。

胆囊管结石；腹腔镜胆囊切除术

CysticDuctLithiasisDuringSelectiveLaparoscopicCholecystectomy:ClinicalStudyof29CasesXiChunhua,SunYueming,FuZan,etal.DepartmentofGeneralSurgery,FirstAffiliatedHospitalofNanjingMedicalUniversity,Nanjing,China

ObjectiveTostudytheincidenceandtreatmentofcysticductlithiasis(CDL)duringselectivelaparoscopiccholecystectomy.MethodsAtotalof29casesofCDLamongcasesofselectivelaparoscopiccholecystectomyfromJunetoDecemberwereretrospectivelyanalyzed.Theclinicalmanifestation,diagnosticmethods,andoperativestrategieswereanalyzed.ResultsAmongthe29cases,therewere16casesofoccultCDL,12obstructiveCDL,and1caseofMirizzisyndrome.Allthestoneswereremoved.Commonbileductstone(CBDS)occurredin8cases(27.6%).Postoperativefollow-upsfor6-20months(mean,10months)inthe29casesfoundnobiliarystenosisorresidualstones.ConclusionCysticductlithiasisisfoundfrequentlyduringselectivelaparoscopiccholecystectomy.Preoperativediagnosisisdifficult,leadingtoahighrateofoccultCDL.TheexplorationforCDLand







































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