LC和EST联合治疗胆囊结石合并胆总管结石.docLC和EST联合治疗胆囊结石合并胆总管结石 作者:张辉常奇蒙丁峻岭周鸣王学志 【关键词】 LC 摘要:目的:评价腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)和内镜下Oddi括约肌切开取石术(endoscopic sphincterotomy,EST)联合治疗胆囊和胆管结石病的方法和价值。方法:对40例经B超或CT、MRCP检查证实为胆囊结石合并胆总管结石病人先行EST取石再行LC。结果:40例病人完成EST取石和39例病人完成LC,1例中转进腹,1例LC后经鼻胆管造影见结石残留后再次内镜取石。结论:联合应用 LC和EST治疗胆囊结石合并胆总管结石是一种安全有效的治疗方法。 关键词:胆结石;胆总管结石;腹腔镜胆囊切除术;内镜括约肌切开 LC bined on Bile Duct Stones Abstract: Objective: To evaluate the technique and value of the bination of laparoscopic cholecystestomy(LC) and endoscopic sphincterotomy(EST) in the treatment of cholecystolithiasis and mon bile duct stones(CBD). Method: 40 patients diagnosed as cholecystolithiasis on bile duct stones by B-ultrasonography or puter tomography(CT) and MRCP underong y. One case of residual stone formed by nasol-biliary tract opacifiacion after LC accepted a second time endoscopic stone removement. Conclusion: bination of laparoscopic and endoscopic procedure is a safe and effective method to treat the patients suffering from cholelith of the gallbladder and CBD. Key on bile duct stones;Laparoscopic cholecystestomy;Endoscopic sphincterotomy 胆石症长期以来都是外科临床上常见病、多发病。在电视腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)和内镜下Oddi括约肌切开取石术(endoscopic sphincterotomy,EST)已分别成功在临床上应用多年的基础上。Palma、秦明放等[1,2]报道了二镜联合治疗胆囊结石合并胆总管结石的经验,但也存在一定争议[3]。我院外科于2000年至今对40例胆囊结石合并胆总管结石病人进行了腹腔镜内镜联合治疗,取得了良好的疗效,现报告如下。 1临床资料 :自2000年7月至2003年12月,我院外科共对40
