[摘要] 目的 对有胆道手术史的肝胆管结石患者行腹腔镜胆总管切开取石术，探讨其疗效和安全性。 方法 2010年4月—2014年9月，共收治96例肝胆管结石患者，其中有胆道手术史者38例(A组)、无手术史者58例(B组)，均采用腹腔镜下胆管切开取石术予以治疗。比较两组患者的手术时间、出血量、近期并发症和远期并发症发生情况。 结果 所有患者术后随访12～60个月，两组患者临床症状、结石分布情况、取石方式等方面进行比较，差异无统计学意义(P>0.05)。两组手术时间比较差异无统计学意义(P>0.05)，A组术中出血量明显大于B组(P0.05)。结论 对于有胆道手术史的肝胆管结石患者行腹腔镜胆总管切开取石术，是一项安全有效的微创手术方式，值得在临床推广应用。
[关键词] 肝胆管结石；腹腔镜；胆总管切开取石；肝切除
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2015)10(a)-0001-03
Analysis of the Safety of Laparoscopic Choledocholithotomy in the Treatment of Patients with Hepatolith and the History of Biliary Tract Operation
YIN Zhen， SUN Wei-hua
Department of General Surgery， Huaihua Second People's Hospital， Huaihua， Hunan Province， 418000 China
[Abstract] Objective To investigate the effect and safety of laparoscopic choledocholithotomy in the treatment of patients with hepatolith and the history of biliary tract operation. Methods A total of 96 cases with hepatolith admitted from April 2010 to September 2014 were divided into group A(38 cases) and group B(58 cases). Patients in group A had the history of biliary tract operation， while those in group B had not. Both groups were treated by laparoscopic choledocholithotomy. And the duration of operation， amount of bleeding， incidence of short-term and long-term complications were compared between the two groups. Results All the patients were followed up for 12～60 months after surgery. The differences in the clinical symptoms， distribution of stones， method of removing stones were not statistically significant(P>0.05). There was no statistically significant difference in duration of operation between the two groups (P>0.05). The amount of intraoperative bleeding in group A was much more than that in group B(P0.05). Conclusion For patients with hepatolith and the history of biliary tract operation， laparoscopic choledocholithotomy is a safe and effective minimally invasive surgery， and it is worthy of clinical application and promotion.
[Key words] Hepatolith； Laparoscope； Choledocholithotomy； Hepatectomy
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