腹腔镜胆总管探查术治疗胆总管结石的现状与进展

Current status and progress of laparoscopic common bile duct exploration in the treatment of choledocholithiasis

  • 摘要: 胆总管结石多继发于胆囊结石,治疗以手术为主。近年来随着微创技术的不断进步,胆总管结石的治疗从传统开腹手术转变为腹腔镜胆总管探查术(LCBDE)。LCBDE具有创伤小、术后恢复快、并发症少等优势,目前已得到广泛开展。LCBDE有经胆囊管和经胆总管两种途径,经胆囊管途径虽然创伤更小但适用范围较窄。LCBDE术后一期缝合术与T管引流术比较,对机体影响更小,正逐步得到推广。倒刺缝线在腹腔镜下胆总管缝合中的应用也引起研究者越来越多的关注。笔者结合本团队临床经验,就LCBDE治疗胆总管结石的现状及进展进行深入探讨。

     

    Abstract: Most of choledocholithiasis is secondary to gallbladder stone, and surgery remains the main treatment mode. In recent years, with the continuous improvement of minimally invasive techniques, the treatment of choledocholithiasis has changed from the traditional open surgery to laparoscopic common bile duct exploration (LCBDE). LCBDE has been widely carried out based on the advantages of small damage, rapid postoperative recovery and few complications. Two methods of LCBDE include through cystic duct and through common bile duct, although through cystic duct LCBDE has smaller damage, application range is narrow. Compared with T-tube drainage, primary suture of common bile duct after LCBDE has less effects on the body and is being promoted gradually. The application of barbed stitches in laparoscopic common bile duct suture has attracted increasing attention. This article reviews the current status and progress of LCBDE in the treatment of choledocholithiasis.

     

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