摘要
目的评价十二指肠镜和胆道镜联合治疗胆总管末段嵌顿残余结石的方法和疗效。方法回顾性分析1998年3月—2010年5月98例胆总管末段嵌顿残余结石患者,包括急性重症胆管炎术后20例,胆囊结石继发胆总管结石术后66例,肝胆管结石术后12例,经十二指肠镜和胆道镜联合治疗的临床资料。结果 98例患者十二指肠镜和胆道镜联合治疗技术均实施成功,一次成功取石成功者95例(96.9%),二次取石成功者3(3.1%)例,所有患者胆总管末段嵌顿残余结石均被取净。1例发生急性胰腺炎(1.0%),9例发生高淀粉酶血症(9.2%),无胆道穿孔、出血等严重并发症。结论十二指肠镜和胆道镜联合治疗胆管残余结石具有安全、有效、操作简单、微创等优点,是治疗胆总管末段嵌顿残余结石的理想选择。
Objective To evaluate the method and effect of combination treatment with duodenoscope and choledochoscope for impacted residual bile duct stones.Methods From March 1998 to May 2010,98 cases of residual bile duct stones,including 20 cases of postoperative acute severe cholangitis,66 cases of postoperative choledocholithiasis and 12 cases of postoperative hepatolithiasis,were treated by combination of duodenoscope and choledochoscope,and the clinical data were retrospectively analyzed.Results The technique of combination of duodenoscope and choledochoscope was implemented successfully in all patients.In 95 of the 98 patients,stones were extracted successfully in the first session of combined treatment procedure（96.9%）,and in 3 cases stones were extracted successfully in a second session（3.1%）.The success rate of stone removal was 100%.The impacted stones of all patients were completely cleared without serious complications such as biliary tract perforation or hemorrhage.Acute pancreatitis occurred in 1 case（1.0%） and 9 cases had hyperamylasemia（9.2%） after the procedures.Conclusions The technique of combination of duodenoscope and choledochoscope for treatment of impacted residual bile duct stones is safe,effective,simple and minimally invasive,which is an ideal choice for treatment of impacted residual bile duct stones.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2011年第2期136-138,共3页
China Journal of General Surgery
