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首页> 外文期刊>Surgical Endoscopy >Evaluation of laparoscopic management of common bile duct stones in 220 patients.
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Evaluation of laparoscopic management of common bile duct stones in 220 patients.

机译：腹腔镜治疗胆总管结石220例评价

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BACKGROUND: The aim of this study was to evaluate the feasibility and results of laparoscopic management of common bile duct stones (CBDS). METHODS: From October 1990 to November 1996, 220 patients with CBDS have been managed laparoscopically. CBDS were suspected or diagnosed preoperatively in 130 patients (59.1%) and at intraoperative cholangiography (IOC) in 90 patients (40.9%). A transcystic duct extraction (TCDE) was attempted in 112 patients and a primary choledochotomy in 108 patients. RESULTS: TCDE was successful in 77 cases (68.8%). The 35 failures were treated by 29 laparoscopic choledochotomies, 1 intraoperative and 5 postoperative endoscopic sphincterotomies (ES). A choledochotomy was thus performed in 137 cases and was successful in 133 cases (97.1%). The four failures were managed by three laparotomies and one postoperative ES. The overall success rate was 95.5% (210/220). There was 4 deaths (0.9%) within the 1st postoperative month in ASA 3 patients and the morbidity rate was 9.1% (20/220). There were 7 residual stones (3.2%). CONCLUSIONS: Laparoscopic desobstruction of CBDS appears to be safe and effective and has the advantage to be a single-stage procedure. It could become in the future with refinement of instrumentation and skill of surgeons the best treatment for the majority of patients harboring CBDS.
机译：背景：本研究的目的是评估腹腔镜治疗胆总管结石（CBDS）的可行性和结果。方法：1990年10月至1996年11月，对220例CBDS患者进行了腹腔镜治疗。术前怀疑或诊断出CBDS的患者为130例（59.1％），术中胆道造影（IOC）的患者为90例（40.9％）。尝试了112例患者进行了膀胱穿刺术（TCDE），并尝试了108例患者进行了初次胆总管切开术。结果：TCDE成功77例（68.8％）。通过29例腹腔镜胆总管切开术，1例术中和5例术后内窥镜括约肌切开术（ES）治疗了35例失败。因此，进行了137例胆总管切开术，其中133例成功（97.1％）。四个失败的原因是三个开腹手术和一个术后ES。总体成功率为95.5％（210/220）。 ASA 3例患者在术后第一个月内有4例死亡（0.9％），发病率为9.1％（20/220）。有7块残留的结石（3.2％）。结论：腹腔镜CBDS梗阻似乎是安全有效的，并且具有单阶段手术的优势。随着仪器的完善和外科医生技能的提高，将来可能成为大多数CBDS患者的最佳治疗方法。

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