十二指肠胆总管切开术

Objective:To observe the clinical results of LC combined with EST in treating cholecystolithiasis and choledocholithiasis.

目的： 总结腹腔镜胆囊切除术＋十二指肠乳头括约肌切开术治疗胆囊、胆总管结石的体会。

Methods:The clinical data of 6 cases that received LC combined with EST herapy for cholecystolithiasis and choledocholithiasis were analyzed retrospectively.

目的：总结腹腔镜胆囊切除术＋十二指肠乳头括约肌切开术治疗胆囊、胆总管结石的体会。方法：为6例患者行LC＋EST。

Results: Among 80 cases of ACST, 76 cases were successfully implemented LC, gallbladder puncture and decompression choledocholithotomy T-tube drainage were performed in 11 cases, choledocholithotomy T-tube drainage in 15 cases, common bile duct gall bladder fistula Toishi T-tube drainage in 14 cases, gallbladder removal choledocholithotomy T-tube drainage in 36 cases, operative time 15-120 min, bleeding 10-80 ml; 4 cases transitted laparotomy, 1 case of gallbladder and surrounding tissue adhesion serious, ampulla signs disappear, and the hepatoduodenal ligament ill-defined, 2 cases of gallbladder contraction deep within the liver, gallbladder triangle scar adhesions, and 1 case of duct stone impaction and severe adhesions; postoperative hospital stay was 8-11 d, all were well recovered; pathological diagnosis, acute cholecystitis in 41 cases （51.2％）, acute suppurative cholecystitis in 24 cases （30.0％）, acute gangrenous cholecystitis in 15 cases （18.8％）.

结果：重症急性胆囊炎80例，76例成功实施LC，其中，胆囊穿刺减压胆总管切开取石T管引流11例，胆总管切开取石T管引流15例，胆囊造瘘胆总管切开取石T管引流14例，胆囊切除胆总管切开取石T管引流36例，手术时间15～120 min，术中出血10～85 ml；4例中转开腹，其中，1例胆囊与周围组织粘连严重，壶腹部标志消失，与肝十二指肠韧带界限不清，2例胆囊萎缩深陷肝脏内，胆囊三角区瘢痕粘连，1例胆囊管结石嵌顿且严重粘连，术后住院时间8～11 d，术后恢复均良好，治愈出院；80例术后病理诊断，急性单纯性胆囊炎41例（51.2％），急性化脓性胆囊炎24例（30.0％），急性坏疽性胆囊炎15例（18.8％）。

Medical School of Xian Jiaotong University, Xian 710061, ChinaABSTRACT: Objective To evaluate the efficacy and safety of endoscopic sphincterotomy in treating common bile duct stone or strictive papillitis, and then analyze possible related risk factors for longterm complications after EST.

目的 探讨内窥镜下十二指肠乳头括约肌切开术(endoscopic sphincterotomy， EST)对胆总管结石、十二指肠乳头狭窄等疾病的治疗效果，并对术后出现的远期并发症的可能危险因素进行分析。

Objective To compare the effects of endoscopic sphincterotomy vs endoscopic papillary balloon dilation in the treatment of choledocholith and to explore the indications for these two techniques.

目的 比较内镜下十二指肠乳头切开术与十二指肠乳头球囊扩张术两种方法治疗胆总管结石的优点和缺点，探讨两种方法的适应证。

But we don't care about Battlegrounds.

但我们并不在乎沙场中的显露。

Ah! don't mention it, the butcher's shop is a horror.

啊！不用提了。提到肉，真是糟透了。