腹腔镜带蒂胆囊瓣胆道修复术治疗合并 肝门部胆管狭窄的肝内胆管结石

Laparoscopic cholangio plasty with pedicled gallbladder flap treat hepatolithiasis with hilar bile duct stricture

摘要:

目的 探讨腹腔镜带蒂胆囊瓣胆道修复术治疗合并肝门部胆管狭窄的肝内胆管结石的安全性和可行性。方法 2011年11月～2012年2月，对5例合并肝门部胆管狭窄的肝内胆管结石患者施行腹腔镜带蒂胆囊瓣胆道修复术，5例均为女性；年龄25～60岁，平均47.4岁。手术方式为腹腔镜胆总管切开，胆道镜探查取石，部分胆囊切除，狭窄部胆管切开，带蒂胆囊瓣胆道修复，T管引流术，其中有2例患者切除左肝外叶。结果 5例均成功完成腹腔镜带蒂胆囊瓣胆道修复术，无中转开腹。结论 腹腔镜带蒂胆囊瓣胆道修复术治疗合并肝门部胆管狭窄的肝内胆管结石是安全可行的。

Abstract:

【Objective】 The aim of the study was to explore the security and feasibility of laparoscopic cholangio plasty with pedicled gallbladder flap to treat hepatolithiasis with hilar bile duct stricture. 【Methods】 Laparoscopic hilar cholangio plasty with pedicled gallbladder flap was performed for five patients who suffered from hepatolithiasis with hilar bile duct stricture from November 2011 to February 2012. They were all female, aged from 25 to 60 years, average 47.4 year. The operative methods were laparoscopic choledochotomy, hepatolithotomy, choledochoscopy, partial cholecystectomy, stenosis of bile duct incision, hilar cholangio plasty with pedicled gallbladder flap, T tube drainage. Left lateral lobectomy was performed in two patients. The clinical data of these five patients was investigated retrospectively. 【Results】 All of the five patients were successfully performed laparoscopic hilar cholangio plasty with pedicled gallbladder flap. There was no conversion to open technique. 【Conclusion】 Laparoscopic hilar cholangio plasty with pedicled gallbladder flap is a safe and feasible method for hepatolithiasis.