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首页> 外文期刊>Surgical Endoscopy >Laparoscopic endobiliary stenting as an adjunct to common bile duct exploration.
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Laparoscopic endobiliary stenting as an adjunct to common bile duct exploration.

机译：腹腔镜胆道内支架术可作为胆总管探查的辅助手段。

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BACKGROUND: The management of common bile duct stones (CBDS) in the era of operative laparoscopy is evolving. Several minimally invasive techniques to remove CBDS have been described, including preoperative endoscopic retrograde cholangiopancreatography (ERCP), postoperative ERCP, lithotripsy, laparoscopic transcystic common bile duct exploration, and laparoscopic choledochotomy with common bile duct exploration (CBDE). Because of the risks and limitations of these procedures, we utilize laparoscopically placed endobiliary stents as an adjunct to CBDE. METHODS: Sixteen patients underwent laparoscopic common bile duct exploration (LCBDE) by either choledochotomy or the transcystic technique with placement of endobiliary stents. These patients were identified during laparoscopic cholecystectomy as having occult choledocholithiasis, using routine dynamic intraoperative cholangiography. RESULTS: CBDS were successfully removed in all patients as demonstrated by completion cholangiography and intraoperative choledochoscopy. Eighty percent of patients were discharged the following day; the first three patients in this series were observed for 48 h prior to discharge. No patient required T-tube placement and closed suction drains were removed the morning after surgery. Stents were removed endoscopically at 1 month. Six- to 30-month follow-up demonstrates no complications to date. CONCLUSIONS: Laparoscopic endobiliary stenting reduces operative morbidity, eliminates the complications of T-tubes, and allows patients to return to unrestricted activity quickly. We recommend laparoscopically placed endobiliary stents in patients undergoing LCBDE.
机译：背景：在腹腔镜手术时代，胆总管结石（CBDS）的管理正在发展。已经描述了几种去除CBDS的微创技术，包括术前内镜逆行胰胆管造影（ERCP），术后ERCP，碎石术，腹腔镜经囊性胆总管探查术以及腹腔镜胆总管切开术与胆总管探查术（CBDE）。由于这些程序的风险和局限性，我们使用腹腔镜放置的胆道内支架作为CBDE的辅助手段。方法：16例患者接受了胆总管切开术或经胆囊镜置入胆道内支架置入腹腔镜胆总管探查术（LCBDE）。使用常规动态术中胆道造影术，在腹腔镜胆囊切除术中将这些患者确定为隐匿性胆总管结石。结果：所有胆囊造影和术中胆道镜检查均证实，所有患者均成功清除了CBDS。第二天出院的病人占80％;出院前观察该系列的前三名患者48小时。术后第二天早上，无需患者放置T型管，并移除闭合的引流管。 1个月内镜下摘除支架。六个月至30个月的随访表明，迄今为止尚无并发症。结论：腹腔镜胆道内支架术可降低手术发病率，消除T型管的并发症，并使患者迅速恢复不受限制的活动。我们建议在接受LCBDE的患者中通过腹腔镜放置胆管支架。

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