摘要
肝胆胰术中应用胆道镜技术212例。术后胆道残石率从34.5％降低为9.5％,118例肝内胆管结石中46例术中镜检发现合并肝胆管狭窄,其中16例膜状狭窄者在术中胆道镜(IOC)指引下施行有效扩张;32例胆总管下端梗阻者经镜检明确诊断(其中取活检24例)。据此施行的9例胰十二指肠切除无1例误切,16例镜检为良性狭窄者随访6月至10年,均存活;18例疑有胆总管结石者经扩大的胆囊管径路镜检,13例无阳性发现而免于胆总管切开。作者认为,IOC技术的应用有利于肝胆胰手术方式的选择,对术前未能确诊的胆总管下端病变,既可避免肿瘤的漏诊漏治,又可免除不必要的、创伤较大的根治性切除手术。
In this study, 212 cases of operations on the liver, biliary tract and pancreas underwent intra - operative choledochoscopy ( IOC). Thirty - two cases of obstruction in the lower end of the bile duct were diagnosed by this technic and 9 cases of 32 received right pancreatoduodenectomy according their diagnosis. Fourteen cases avoided choledocholithotomy by means of IOC's exploration through enlarged ductus cysti-cus in 18 cases which were doubted of choledocholithiasis. This paper concludes that IOC is very useful for choosing operative mode on lower choledochus diseases including hepatolithiasis and may change an intricate operative mode to an easier and simpler part. On the other hand, IOC can assuredly avoid leaving out the diagnosis and delaying the treatment of the cancer.
出处
《中国现代手术学杂志》
1998年第1期13-15,共3页
Chinese Journal of Modern Operative Surgery
关键词
术中
胆道镜技术
肝胆胰术式
术式选择
endoscopy, digestive system
surgery, operative
intraoperative period
choosing of operative mode
