结石

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％）。

Methods In vitro,the sets of stones containing71%～86%pigment bile were obtained from30paˉtients following cholecystectomy and choledochostomy.

取外科手术中30例不同患者肝胆管结石，化学分析测定胆色素含量为71%～86%，红外光谱分析测定是胆色素为主。

Methods In choledochotomy of 32 cases,make sure it is unabstructed after cleaning all the stones and ascaricls,then it is sewed up primarily and conformed by cholangiongraphy.

对32例患者行胆道探查，取尽结石或蛔虫，检查胆总管下段通畅，经胆囊管胆道造影后一期缝合胆管。

There were no severe complications occured in the patients who underwent primary closure.Conclusions:Laparoscopic choledochotomy and primary ductal submucosa closure has the advantage of less invasion,less complication and shorter hospitalization.It is a safe and effective operation for patients who have the indication.

应用腹腔镜胆总管切开取石一期缝合术治疗胆管结石具有创伤小、住院时间短及并发症少的优势，对符合适应证的患者是一种安全、有效的术式，但应掌握操作技巧以提高手术成功率、防止胆漏的发生。

Methods 34choledocholithasis patients were treated by cholecystectomy and choledochotomy under laparoscopy combined with fibro-optic choledocoscopy,and one-stage suture or T-shaped-tube drainage.

对34例胆总管结石患者在腹腔镜下行胆囊切除、胆总管切开、纤维胆道镜取石后行一期缝合或T管引流。

Methods:The clinical data of twenty nine patients with common bile duct calculi underwent laparoscopic choledochotomy and primary ductal submucosa closure without routine T tube drainage was retrospectively analyzed.

应用腹腔镜手术设备及纤维胆道镜为29例胆总管结石患者行腹腔镜胆总管切开取石术，不置T管引流，一期缝合胆总管壁。

When B-ultrasound and X-ray were used combinedly,diagnosis rate and accuracy were elevated.Surgical treatment should be applied to cases diagnosed determinedly.Cholecystectomy is an effective method to treat cholecystolethiasis and choledochotomy should be controlled strictly in use.

小儿胆石症缺乏典型症状，对有腹痛和黄疸者首选B超检查，结合腹部X线平片可提高诊断率；诊断确定应行手术治疗，胆囊切除是治疗胆囊结石较好术式，胆总管切开应严格掌握指征。

Main methods included choledochotomy, choledochoscopic exploration,ureteral catheter through cystic duct remnant for drainage of bile duct,Ttube drainage,and the primary closure of duct incision.

1993年10月至2005年3月运用腹腔镜胆总管切开取石术(包括胆总管切开，胆管镜取石，经胆囊管残端输尿管导管胆管引流、T管引流、胆总管切口即时缝合等)有选择地对87例胆总管内径≤08cm的胆总管结石病人进行治疗。

To investigate the prevention, diagnosis and treatment of cholelith in residual gallbladder after cholecystectomy so as to reduce morbidity of cholelith in residual gallbladder.

目的：探讨胆囊切除术后残余胆囊结石的诊治和预防方法，减低此并发症的发生率。

Methods: Fifty-six cases of cholelith in residual gallbladder after cholecystectomy were analysed retrospectively. Among them, 18 patients under went conventional cholecystectomy, 16 patients underwent mini-lap cholecystectomy, 22 patients underwent laparoscopic cholecystectomy; 30 patients under went emergency operation and 26 patients under went selective operation; 42 patients' first operation was performed by under grade three hospital and 14 patients were performed by up gradethree hospital.

对56例残余胆囊结石再次手术的病例进行回顾性分析。56例中初次手术行经典胆囊切除术18例，小切口胆囊切除术16例，腹腔镜胆囊切除术22例；急诊手术30例，择期手术26例；初次手术在三级以下医院施行42例，在三级以上医院施行14例。

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。