摘要
目的探讨肝外胆管残余结石的诊断和治疗。方法回顾性分析110例肝外胆管残余结石诊治的临床资料;胆囊切除术胆总管残余结石18例,胆总管探查术后残余结石92例。在院T管造影诊断40例,胆绞痛发作9例,出院61例中,3月内,6月内,1年内出现症状分别为31例(50.8%),22例(36.0%)和8例(13.1%)。结果经T管窦道取石30例,内镜下经Oddi’s括约肌切开取石37例,胆总管切开取石后再置T管20例,作胆肠吻合术13例,Oddi’s括约肌切开成形术10例。结论要预防残石发生应正确掌握胆总管探查指征及技巧并采取术中胆道造影和使用胆道镜等措施。术后常规T管造影﹑B超、MRCP﹑ERCP是诊断的有效措施。根据不同情况,施行相应的治疗。
Objective To analysis the extrahepatic billiary residual stone in 110 cases. Methods The clinical data of residual stone of extrahepatic bile duct in 110 cases were reviewed. Choledochal residual stone of postchlecystectomy was seen in 18 cases. Post-choledocholithotomy in 92. They are diagnosed after ＂T＂ tube cholangiography in 40 inpatient cases and diagnosed by gallstone colic in 9 inpatient cases. In 61 outpatient cases, symptoms presented within 3, 6, 12 months were 31, 22, and 8 cases respectively. Results Cholelithotomy was performed through ＂T＂ tube sinus in 30 cases and through sphincterotomy endoscopically in 37. Post-chlelithotomy ＂T＂ tube re-insertion was carried out in 20, cholangio-enterostomy in 13, Oddi＇s sphincteroplasty 10 cases. Conclusion For preventing the reoccurrence of the residual stone, indication and skill of cholulocho-exploration should be correctly grasped and cholangiography in operation and cholangioscope should be adopted. Postoperative routine cholangiography, B-uhrosonography, MRCP, ERCP are effective diagnostic method. According to different condition, appropriate treatment should be carried out.
出处
《肝胆胰外科杂志》
CAS
2008年第2期119-121,共3页
Journal of Hepatopancreatobiliary Surgery
关键词
肝外胆管残余结石
胆总管探查
T管造影
extrahepatic biliary residual stone
cholelocho-exploration
＂T＂ tube cholangiography
