摘要
目的 :总结硬质胆镜治疗疑难肝内胆管结石的疗效。方法 :对 1 991年至今硬质胆镜治疗疑难肝内胆管结石 2 67例作分析。治疗途径分别有术中胆镜取石、左肝小切口、皮下盲襻和术后瘘道取石 ;取石方法包括吸引法、钳夹法、蚕食碎石、超声碎石、胆镜扩张和扩张子扩张法。结果 :按照纤维胆镜取石的治疗标准成功 2 62例。失败 5例。术中胆镜取石成功率为 99.2 % (1 2 4 / 1 2 5例 ) ,术后瘘道取石成功率97.7% (83/ 85例 ) ,经皮下盲襻取石成功率 97.1 % (34/ 35例 ) ,经左肝小切口取石成功率 95.5% (2 1 / 2 2例 ) ,无严重并发证。结论 :硬质胆镜治疗疑难肝内结石疗效满意 ,强调手术、内镜、碎石、术中 B超、术中造影等相互配合方能取得更好疗效。
Objective:To summarize the effect of rigid choledochoscope on the treatment of intractable hepatolithiasis.Methods:A total of 267 patients with intractable hepatolithiasis had been treated with rigid choledochoscope since 1991.The removal routes included intraoperative cholangiotomy,left intrahepatic cholangiotomy,subcutaneous blind loop of cholangiojejunostomy and postoperative biliary fistula.The removal techniques involved aspiration,clipping,warm biting,ultrasonolithotripsy,bile duct dilation with choledochoscope or dilator.Results:According to the cure criterion used in fiber choledochoscopy,262 cases were successfully treated and 5 failed.The rates of stone removal by way of intraoperative cholangiotomy,postoperative biliary fistula,subcutaneous blind loop of cholangiojejunostomy and left intrahepatic cholangiotomy were 99.2%(124/125),97.7%(83/85),97.1%(34/35)and 95.5%(21/22),respectively.There were no serious complications.Conclusion:The use of rigid choledochoscope can acquire a satisfactory result in the treatment of intractable hepatolithiasis.It is stressed that only by the perfect coordination between operation,choledochoscope,lithotripsy,intraoperative B mode ultrasonography and cholangiography can the best result achieve.
出处
《广东医学院学报》
2002年第5期349-350,共2页
Journal of Guangdong Medical College
关键词
硬质胆镜
治疗
肝内结石
胆管狭窄
超声碎石
choledochoscope
hepatolithiasis
stenosis of biliary tract
ultrasonolithotripsy
