The treatment of gallbladdercalculi and common bile duct calculi with laparoscope combined with endoscope
Gallstones secondary to common bile duct stones account for approximately 11%. Traditional laparoscopy cholecystectomy, common bile duct incision patients with stone and T-tube drainage have large trauma, many postoperative complications, and hospitalization.length of time. Minimally invasive treatment of cholecystolithiasis complicated with common bile duct stones in recent years
The main methods are (1) LCB+DE: namely in LC surgery, cholangiography sees common bile duct stones before resection the gallbladder is re-incised and the common bile duct is inserted into the choledochoscope for bile duct exploration and stone extraction;
(2) LTCL: Laparoscopic cholecystectomy through the cystic duct with cholangioscopic lithotripsy
(3) Combination of EST and LC: that is, through ERCP+ES cholangiography see common bile duct stones after incision of the duodenal papillary muscle row stone; gallbladder removed by LC. The first two methods require certain equipment and has certain difficultiesEST combined with LC in the treatment of cholecystolithiasis combined with common bile duct stones, the operation is simple, safe, reliable, easy to master, convenient.
It is widely used and has the following advantages:
(1) Preoperative cholangiography is beneficial to
The surgeon estimates the difficulty of the operation and chooses the treatment method Elimination of LC the hidden danger of failure; (2) it is helpful to understand the patient's gastroduodenum and nipple
(3) For patients with obstructive jaundice, cholangitis, cholelithiasis
EST or ENBD may
Relieve the obstruction, drain the biliary tract, promote inflammation resolution, expand the scope of LC surgery circumference reduced the recurrence rate of postoperative bile duct stones. This law has also been implemented
For several years, there has been debate on the surgical sequence EST first, or LC first, the indication for ERCP, and the time between EST and LC.
