摘要
目的 :探讨为接受胆管结石清除术后残留结石的患者采用胆道镜联合钬激光碎石术进行治疗的临床效果。方法 :选择2012年2月至2018年3月期间在太仓市第一人民医院肝胆外科接受治疗的24例胆管结石清除术后存在残余结石的患者作为研究对象。对这24例患者均进行胆道镜联合钬激光碎石术。然后,观察这24例患者治疗的效果、并发症的发生率及病情的复发率。结果:这24例患者均顺利完成手术。在这24例患者中,一次性取尽残余结石的患者有23例,经二次手术操作取尽残余结石的患者有1例。这1例患者胆管内的残余结石嵌顿在其胆管和胰管的壶腹部,故转为对其进行ERCP(经内镜逆行性胰胆管造影术),并成功取出结石。术后,这24例患者均未出现严重的并发症。对这24例患者进行为期一年的随访发现,其均未发生胆管炎、胆管炎性狭窄等并发症,且未出现结石复发的情况。结论 :为接受胆管结石清除术后残留结石的患者采用胆道镜联合钬激光碎石术进行治疗的效果较好,安全性较高。
Objective:To explore the clinical value of holmium laser in treating residual stones after biliary tract surgery. Methods:Retrospective analysis 24 Cases of residual stones after biliary tract surgeryin February 2012 to March 2018, routine through the T tube Doudaozhi into the bile duct.If the stones are large or embedded, which could not be removed with a stone on top, with holmium laser lithotripsy under choledochoscope to look straight, and then with a stone on top out or rinse out. Results: 24 patients in this group, 23 patients were successfully stone removal, while one patient failed because the stone was located in the ampulla of the biliary pancreas and could not go deep into the biliary tract mirror. All patients did not have the complications of biliary tract hemorrhage and bile duct injury during the operation, and there were no signs of bile duct stenosis or stone recurrence during the follow-up for 1 year. Conclusion:Holmium laser has the advantages of easy operation, accurate lithotripsy, safety and effectiveness in treating residual stones after biliary tract surgery.
作者
徐海宾
汪意清
Xu haibin;Wang yiqing(The first people's hospital of Taicang (Taicang Hospital Affiliated to Soochow University)Hepatobiliary surgery Jiangsu taicang 215400)
基金
腹腔镜下胆总管结石治疗方法的研究
基金项目编号:SYSD2017030
计划类别:民生科技医疗卫生应用基础研究
关键词
钬激光
胆道镜
肝内外胆管结石
残余结石
Holmium laser
Fibrocholedochoscope
Intrahepatic and extrahepatic bile duct stones
Residual calculi
