摘要
目的:探讨经皮肾镜在复杂性胆管结石中的临床应用疗效.方法:回顾性分析2013-01/2015-03在宜春市人民医院运用经皮肾镜治疗的73例复杂性胆管结石患者临床资料.所有病例术前都行B超、计算机断层扫描或者核磁共振成像确诊,排除凝血功能异常、顽固性高血压和严重脏器功能障碍的病例后,开始实施经皮肾镜取石手术.术后通过采用门诊、电话、手机短信或微信等方式进行随访,随访时间截至2015-08.结果:2013-01/2015-03在宜春市人民医院经皮肾镜联合气压弹道碎石共治疗肝内外胆管结石73例,碎石成功率达到100%.其中1次性取净结石48例(65.8%),2-3次取净结石22例(30.1%),3-4次取净结石3例(4.1%).术后l例肝内弥漫性结石女性患者经过4次经皮肾镜联合气压弹道碎石治疗.73例患者中,联合行左肝外叶切除术7例,胆肠吻合术2例.术后3例留置T管的患者术后瘘管处出血,术后腹胀呕吐2例,无其他严重并发症发生.73例患者拔除T管后随访3-12 mo,平均随访10 mo,肝内胆管结石复发率为3/73.结论:经皮肾镜治疗复杂性胆管结石具有术中术野清晰,清除结石效率高,患者手术时间短,术后恢复快,住院时间短,住院费用少等优点,是一种安全、经济、高效的手术方法.
AIM： To assess the clinical nephroscopy in the treatment biliary stones. of percutaneous of complicated METHODS： Clinical data for 73 patients with complicated biliary stones treated by percutaneous nephroscopy at Yichun People＇s Hospital between January 2013 and March 2015 were retrospectively analyzed. All cases were diagnosed by B ultrasound, CT or MRI before operation, and patients with abnormal coagulation function, high blood pressure or severe organ dysfunction were excluded. Patients were followed by outpatient examination, telephone interview, short message or instant messenger （WeChat） till August 2015. RESULTS： The 73 cases of bile duct stones were treated by percutaneous nephroscopy combined with pneumatic lithotripsy. The success rate of lithotripsy was 100%. Among all patients, 48 （65.8%） had successful lithotripsy in the first session, 22 （30.1%） in the second or third session, and 3 （4.1%） in the third or fourth session. A female patient with intrahepatic diffuse stones achieved successful lithotripsy in the fourth session. Of 73 patients,7 underwent left hepatic lobe resection and 2 underwent biliary enteric anastomosis. Three patients with postoperative indwelling T tube developed postoperative bleeding at the fistula site, and there were also two cases of postoperative abdominal distension and vomiting. No other serious complications occurred. The patients were followed for 3 to 12 mo, and the average follow-up duration was 10 mo. The recurrence rate of intrahepatic bile duct stones was 3/73. CONCLUSION： Treatment of complicated bile duct calculi by percutaneous nephroscopy has advantages of high efficiency, short operation time, short hospitalization time and less hospitalization expenses and it is a safe, economical and efficient operation.
出处
《世界华人消化杂志》
CAS
2015年第36期5869-5874,共6页
World Chinese Journal of Digestology
关键词
经皮肾镜
胆管结石
体会
Percutaneous nephroscope
Bile ductstones
Experience
