Abstract: ［Abstract］ Objective To Summarize the clinical experience and effects of laparoscopic common bile duct exploration in patients with a history of upper abdominal surgery. Methods The clinical data of 17 patients undergoing this procedure was collected， the preoperative diagnosis depended mainly on B?ultrasound， CT， ERCP and/or MRCP. Results The procedures were completed successfully in all of 17 patients. Bile leakage occurred in 1 case， which recovered one week after abdominal cavity unobstructed drainage. The operation time ranged from 110 to 215 minutes（mean 160 minutes），and the intraoperative blood loss ranged from 5 to 50 mL （mean 23 mL）， abdominal cavity drainage tube was drawn after one week. Hospital days ranged from 8 to 10 days. Nasal bile duct was drawn from 8 to 10 days after operation. T?tube was drawn from 4 to 8 weeks after operation， and without complications. Conclusion History of upper abdominal surgery is not a contradiction of laparoscopy. The exploration of the common bile duct by laparoscopy can be safe and effective for patients who had undergone operations on the upper abdomen.

Key words: common bile duct stones, common bile duct exploration, abdominal surgery, laparoscopy

摘要： ［摘要］ 目的 总结对有上腹部手术史的患者行腹腔镜下胆总管探查的经验及疗效。方法 回顾性分析17例有上腹部手术史患者行腹腔镜下胆总管探查治疗胆总管结石的临床资料。术前常规行影像检查包括 B超、CT、ERCP、MRCP等。结果 17例手术均成功。术后1例出现胆漏，经引流管通畅引流一周后停止。手术时间约110～215 min，平均160 min。术中出血约5～50 mL，平均23 mL。术后一周左右拔掉腹腔引流管，经过8～10天切口拆线、出院。鼻胆管术后8～10天予以拔除，4～8周后行T管造影无结石，予拔除T管，无不良并发症发生。结论 上腹部有手术史的患者并不是微创手术的绝对禁忌症，对其进行腹腔镜下胆总管探查是安全可靠的。

关键词: 腹腔镜, 上腹部手术史, 胆总管结石, 胆总管探查术