石切除术

From April 2000 to June 2002, 512 cases of laparoscopical urologic operation have been performed through transperitoneal and retroperitoneal or extraperitoneal approach: 41 cases of nephrectomy, 36 cases of radical nephrectomy, 10 cases of nephroureterectomy with cystoscopic en bloc excision of the distal ureter and bladder cuff, 3 cases of partial nephrectomy, 78 cases of partial adrenalectomy or resection of adenomas, 71 cases of total adrenalectomy, 17 cases of ureterolithotomy, 122 cases of decortication of renal cyst, 1 case of Anderson-Hynes dismembered pyeloplasty, 7 cases of renal pedical lymphatics disconnection, 2 cases of relative living donor nephrectomy.

本课题通过对223例肾疾病、149例肾上腺疾病、17例输尿管结石病人进行腹腔镜及后腹腔镜手术，其中肾囊肿去顶术140例、单纯肾切除术41例、根治性肾切除术36例、肾输尿管全切及输尿管口膀胱袖套状切除术10例、后腹腔镜肾部分切除术3例、Anderson-Hynes肾盂成形术1例、肾蒂淋巴管离断术7例、腹腔镜和后腹腔镜活体亲属供肾切取术各1例、肾上腺部分或单纯肿瘤切除术78例、肾上腺全部切除术71例、输尿管切开取石术17例。记录手术时间、手术中失血量、肠道功能恢复时间及并发症，将结果与传统开放手术和国外学者的腹腔镜手术结果进行比较，对数据进行统计分析。

Methods Three hundred and fifty patients for laparoscopic surgery were admitted to our department from August 2001 to February 2002. They included 45 cases of adrenal glands surgery, 55 simple nephrectomy, 25 radical nephrectomy, 11 nephroureterectomy, 3 partial nephrectomy, 110 renal cyst decortication, 4 polycystic kidney decortication, 12 ureterolithotomy, 16 pyeloplasty, 3 retrocaval ureteroplasty, 58 varicocele-varix ligation and 8 pelvic lymph node dissection.

从2001年8月～2004年2月，350例患者施行了腹腔镜下泌尿外科手术，其中肾上腺手术45例，单纯肾切除55例，根治性肾切除25例，肾输尿管全切11例，肾部分切除3例，肾囊肿去顶术110例，多囊肾去顶减压术4例，输尿管切开取石术12例，UPJ成型术16例，腔静脉后输尿管成型术3例，精索静脉高位结扎术58例，盆腔淋巴结切除术8例。

We performed cholecystectomy in 10 cases, cholecystectomy and choledochotomy for common bile duct exploration and stone removal and T-tube drainage in 2, partial cholecystectomy in 3, cholecystostomy in 1. Pathological examination showed that it was AGC in all the patients.

该组行胆囊切除术10例，胆囊切除+胆总管切开取石+T管引流术2例，胆囊大部切除术3例，胆囊造瘘术1例，术后病理报告均为急性坏疽性胆囊炎。

Cases were undergone choledocholithotomy with T-tube drainage , 39 cases cholangiojejunostomy with T-tube drainage , 28 cases lobectomy of liver, 16 cases plastic repair of hepatic portle duct with cholangiojejunostomy.

其中肝胆管切开取石T管引流术47例，肝胆管切开取石+胆肠吻合术39例，肝部分切除术28例，肝门部胆管切开成形+胆肠吻合术16例。

We report a 67-year-old female admitted to our hospital with intermittent fever and upper abdominal pain. She had undergone cholecystectomy and choledocholithotomy 20 years previously. More recently, she had recurrent intrahepatic stones and underwent repeated choledocoscopic lithotiomy and endoscopic lithotripsy.

我们报告一位六十七岁女性因间歇性的发烧及上腹痛而住院，患者曾因胆及胆道结石在二十年前接受了胆囊切除术、胆道取石术，近几年又因复发的瞻道结石及胆管炎接受多次的胆道镜取石术及内视镜取石术。

Results 114 cases were follow-up surveyed from 6 months to 10 years, After operation,the superior rate and residual stone rate were respectively: it was 67.57%、54.05% in the group of choledocholithotomy with T-tube drainage ,78.38%、32.43% in cholangiojejunostomy with T-tube drainage , 96.15%、7.69% in lobectomy of liver, 85.71%、14.29% in plastic repair of hepatic portle duct with cholangiojejunostomy. The total superior rate was 79.82% and total residual stone rate was 31.58%.

结果 114例得到随访，随访6 月～10年，术后优良率及残石率分别：肝胆管切开取石T管引流术67.57%、54.05%，肝胆管切开取石+胆肠吻合术78.38%、32.43%，肝部分切除术96.15%、7.69%，肝门部胆管成形+胆肠吻合术85.71%、14.29%，总优良率79.82%、残石率31.58%。

Results 114 cases were follow-up surveyed from 6 months to 10 years, After operation,the superior rate and residual stone rate were respectively: it was 67.57%、54.05% in the group of choledocholithotomy with T-tube drainage ,78.38%、32.43% in cholangiojejunostomy with T-tube drainage , 96.15%、7.69% in lobectomy of liver, 85.71%、14.29% in plastic repair of hepatic portle duct with cholangiojejunostomy. The total superior rate was 79.82% and total residual stone rate was 31.58%.

结果 114例得到随访，随访6个月～10年，术后优良率及残石率分别为：肝胆管切开取石T管引流术67.57%、54.05%，肝胆管切开取石+胆肠吻合术78.38%、32.43%，肝部分切除术96.15%、7.69%，肝门部胆管成形+胆肠吻合术85.71%、14.29%，总优良率79.82%、残石率31.58%。

Results 114 cases were follow-up surveyed from 6 months to 10 years, after operation,the superior rate and residual stone rate were respectively: it was 67.57%、54.05% in the group of choledocholithotomy with t-tube drainage ,78.38%、32.43% in cholangiojejunostomy with t-tube drainage , 96.15%、7.69% in lobectomy of liver, 85.71%、14.29% in plastic repair of hepatic portle duct with cholangiojejunostomy.

结果 114例得到随访，随访6个月～10年，术后优良率及残石率分别为：肝胆管切开取石t管引流术67.57%、54.05%，肝胆管切开取石+胆肠吻合术78.38%、32.43%，肝部分切除术96.15%、7.69%，肝门部胆管成形+胆肠吻合术85.71%、14.29%，总优良率79.82%、残石率31.58%。

As experience gained more, urologists soon found laparoscopic surgery suitable for many complex upper urothelial tract diseases, such as laparoscopic adrenalectomy, partial nephrectomy, pyeloplasty, nephrolithotomy….etc.

当经验逐渐累积后，泌尿科医师发现腹腔镜手术亦适合众多复杂的手术，例如：腹腔镜肾上腺切除术、部分肾脏切除术、肾盂成型术、肾脏截石术…等。

Under the impression of the sialolithiasis in right Wharton's duct, the patient was admitted for the sialolithotomy.

在右华顿氏管涎石的临床诊断下，病人住院接受右颚下腺导管之涎石切除术。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。