摘要
目的:探讨胆道镜下U-100双频激光碎石术治疗难取性胆管残余结石的临床疗效。方法:42例胆道术后"T"管引流的患者拔除"T"管后,经B超、"T"管胆道造影或CT检查诊断为肝内外胆管残余结石,行胆道镜下U-100双频激光碎石术。结果:29例(69.0%)1次碎石成功,9例(21.4%)碎石2次,4例(9.5%)碎石3次。碎石成功率100%。1次取净结石19例(45.2%),2次取净结石14例(33.3%),3次取净7例(16.7%),结石取净率95.2%。2例因结石位于三级以上胆管,胆道镜及光导纤维不能到达,未完全取净。2例"T"管脱出,因发现及时,重新置管成功:先置入F14尿管,3d后更换较粗尿管直至F20尿管。结论:胆道镜下U-100双频激光碎石术治疗难取性胆管残余结石安全有效。
Objective：To investigate the clinical therapeutic effect of U-100 double-frequency laser lithotripsy in treatment of intractably residual cholelithes under choledochoscopy.Methods：Biliary surgery and T-tube drainage were performed in 42 cases.After the removing of T-tube,B-ultrasound,cholangiography through T-tube or CT was applied to detect residual extra-hepatic and intra-hepatic cholelithes.U-100 double-frequency laser lithotripsy under choledochoscopy was performed on those cases which had positive results.Results：Twenty-nine cases（69.0%） of 42 were treated successfully in the first operation,9 cases（21.4%） obtained satisfactory outcome in the second operation,and 4 cases（9.5%） in the third.All lithotripsies were performed successfully.19 cases（45.2%） got calculus-free status after first operation,14（33.3%） and 7（16.7%） cases obtained that status after the second and third operation respectively.The calculus-free rate was 95.2%.Two cases whose calculi were located in the third level or above bile duct,both choledochoscope and optical fiber were unable to reach,and the calculi were not removed completely.During the treatment,there were 2 cases of T-tube prolapse.Due to the timely discovery,the replacements were successful：initially the F14 urinary catheters were implanted,after 3 days＇ observation,the F14 was removed and replaced with larger catheter till F20.Conclusions：U-100 double-frequency laser lithotripsy under choledochoscopy is an effective and safe treatment for intractably residual cholelithes.
出处
《腹腔镜外科杂志》
2010年第10期760-762,共3页
Journal of Laparoscopic Surgery
关键词
胆结石
碎石术
激光
胆道镜检查
Cholelithiasis
Lithotripsy
laser
Choledochoscopy
