| 硬质胆镜治疗疑难肝内结石的体会 |
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| 引用本文： | 王和鑫,梁志鹏,陈舒燕,张宏武.硬质胆镜治疗疑难肝内结石的体会[J].湛江医学院学报,2002,20(5):349-350. |
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| 作者姓名： | 王和鑫 梁志鹏 陈舒燕 张宏武 |
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| 作者单位： | 广东医学院附属湛江中心医院外科 广东湛江524037
(王和鑫，梁志鹏，陈舒燕)，广东医学院附属湛江中心医院外科 广东湛江524037(张宏武) |
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| 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1991年至今硬质胆镜治疗疑难肝内胆管结石267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、胆镜扩张和扩张于扩张法。结果：按照纤维胆镜取石的治疗标准成功262例。失败5例。术中胆镜取石成功率为99．2％(124／125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％(21／22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。
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| 关 键 词： | 硬质胆镜 治疗 肝内结石 胆管狭窄 超声碎石 |
| 文章编号： | 1005-4057(2002)-05-0349-02 |
| 修稿时间： | 2002年1月30日 |
Rigid choledochoscope in the treatment of intractable hepatolithiasis |
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| Wang He xin,LIANG Zhi peng,CHEN Shu yan,et al.Rigid choledochoscope in the treatment of intractable hepatolithiasis[J].Journal of Guangdong Medical College,2002,20(5):349-350. |
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| Authors: | Wang He xin LIANG Zhi peng CHEN Shu yan |
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| Abstract: | 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. |
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| Keywords: | choledochoscope hepatolithiasis stenosis of biliary tract ultrasonolithotripsy |
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