ERCP 联合腹腔镜治疗胆囊结石伴胆道病变的临床应用【摘要】 目的 探讨逆行胰胆管造影术联合腹腔镜胆囊切除术对胆囊结石伴胆管病变治疗的临床应用。方法 27 例胆囊结石伴胆道病变患者，先用 ERCP、乳头切开术取石；或 ERCP 和鼻胆管引流及柱状气囊扩张术治疗，术后 3～11 天，患者无发热、腹痛，血淀粉酶正常，再按常规四孔法施行 LC。结果 26/27 例成功完成 ERCP 术。18例行 EST 术，1 例用 EPBD，5 例置 ENBD，2例仅造影诊断。15 例胆总管结石全部取尽。25 例病人完成 LC 术，2 例开腹手术。2/27例 ERCP 术后急性轻型胰腺炎，无 LC 和 EST相关并发症。结论 ERCP 联合腹腔镜对胆囊结石伴胆管病变的治疗，符合外科微创诊治理念，是外科微创术式的可靠选择。 【关键词】 腹腔镜胆囊切除术；逆行胰胆管造影术；胆囊结石；胆管病变 The clinical application of the ERCP combined with laparoscopic cholecystectomy for treatment of the cholecystic stone concomitant with bile duct disease:a report of 27 cases 【Abstract】 Objective To explore clinic application of endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) for the treatment of the cholecystic stone combined bile duct 27 patients with cholecystic stone concomitant with bile duct disease were extracted firstly all stones or placed nasobiliary catheter in the bile duct or given endoscopic papillary balloon dilatation (EPBD) by the 3 to 11 days through ERCP,the patients performed LC when they had not fiver,abdominal pain and serum amylase was 26 cases had performed successfully ERCP in 27 patients (%),which of 18 cases were given EST,1 patient used EPBD and 5 cases placed ENBD,another 2 patients given only diagnostic cases of stone in the common bile duct were excluded patients were performed by LC and 2 cases selected by surgical cholecystectomy after were complications with acute pancreatitis in 2 cases (%),that be cured by medic...
