腹腔镜治疗胆总管结石--马谢尔医院第二外科诊所病例系列

E. Moreira, Mauricio Pontillo, R. Hernández, Gustavo Rodríguez Temesio
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引用次数: 0

摘要

背景:胆道结石是普通人群中的一种高患病率疾病,是门诊就诊或急诊室最常见的手术原因之一。由于该疾病的高患病率和潜在的并发症,需要进行治疗。最佳的治疗方案仍然是一个有争议的问题,可以接受手术、内窥镜或经皮治疗。本系列的目的是介绍在Maciel医院第二外科诊所进行的胆总管结石的外科治疗,无论是作为症状表现还是作为术中阴道造影的偶然发现。方法:对2018年1月1日至10月7日期间的所有结肠镜检查记录进行电子检索,选择经术中胆道造影证实的胆总管结石患者。结果:在上述时间段内完成了115例结肠切除术,113例患者进行了腹腔镜结肠池切除术,2例患者进行开放性转换,20例确诊为胆总管结石。用Dormia篮、血管成形术球囊导管、Randall取石钳及生理盐水冲洗取石18例。讨论:经皮或胆总管切开术均可在一次手术中解决疾病。80%的病例术中胆管造影成功,90%的病例结石提取完成,与以前发表的研究没有差异。结论:经胆囊或胆总管切开术是一种安全有效的治疗方法
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tratamiento de la litiasis coledociana por vía laparoscópica, serie de casos de la Clínica Quirúrgica 2 del Hospital Maciel
Background: Biliary lithiasis is a high prevalence disease among general population being one of the most common surgical cause to attend to ambulatory appointment or to the emergency room. Due to the disease high prevalence and the potential complications,  treatment is indicated. The best treatment option is still a matter of debate, admitting either surgical, endoscopic or percutaneous treatment. The aim of this series was to present the surgical management of choledocholithiasis, either as symptomatic presentations or as an incidental finding during intraoperative colangiography, at Surgical Clinic 2, Maciel Hospital. Methods: An electronic search was done among all colecistectomie's records between January 1st and October 7th, 2018, selecting those with choledocholithiasis confirmed by intraoperative cholangiography. Results: 115 colecystectomy were done in the time period previously mentioned, 113 patients had laparoscopic colecistectomies and 2 patients had open conversions, choledocholitiasis was confirmed in 20 cases. Stone clearance was done with Dormia basket, angioplasty balloon catheter, Randall stone forceps and flushing with saline, it was successful in 18 cases. Discussion: Either transcistic or choledochotomy approach allowed to solve the disease in one surgical act. Intraoperative cholangiography was successful in 80% of cases and lithiasis extraction was complete in 90% of cases, no difference with previous published works found. Conclusions: Transcystic or choledochotomy approach is a safe and effective treatment
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