摘要
目的探讨经皮经肝Ⅰ期胆道造瘘(PTOBF)取石术联合硬质胆道镜治疗良性肝胆管狭窄的治疗效果。方法回顾性分析2016年9月至2022年9月广州医科大学附属第一医院使用PTOBF取石联合硬质胆道镜手术治疗的46例肝胆管狭窄合并结石患者的临床资料,其中男性20例,女性26例,年龄(48.5±17.6)岁。分析其结石和狭窄所在位置、结石取净率、术后并发症、狭窄解除率、结石复发率、再次手术率等,总结手术安全性及有效性。结果46例患者共发现58处狭窄,PTOBF取石联合胆道镜处理狭窄手术共77次,近期术后并发症发生率为19.6%(9/46),狭窄解除率为93.5%(43/46)。平均随访(28.1±19.6)个月,最终的结石取净率为91.3%(42/46),结石复发率为19.6%(9/46),再次手术率为8.7%(4/46),远期术后并发症发生率为6.5%(3/46)。结论PTOBF联合硬质胆道镜治疗良性肝胆管狭窄是一种安全可行的方法,能有效减少结石复发及远期术后并发症的发生。
Objective To investigate the therapeutic effect of percutaneous transhepatic one-step biliary fistulation(PTOBF)combined with rigid choledochoscopy in the treatment of benign hepatic bile duct strictures.Methods The clinical data of 46 patients with hepatic ductal stenosis and stones undergoing PTOBF combined with rigid choledochoscopy at the First Hospital of Guangzhou Medical University between September 2016 and September 2022 were retrospectively analyzed,including 20 males and 26 females,aged(48.5±17.6)years.The location of stones and strictures,stone retrieval rate,postoperative complications,stricture release rate,stone recurrence rate,and reoperation rate were analyzed to access the safety and effectiveness of this procedure.Results A total of 58 sites of stenoses were found in 46 patients,and PTOBF lithotripsy combined with rigid choledochoscopy were performed for 77 times.The early postoperative complication rate was 19.6%(9/46),and the stenosis release rate was 93.5%(43/46).The mean follow-up time was(28.1±19.6)months,the complete stone retrieval rate was 91.3%(42/46),the stone recurrence rate was 19.6%(9/46),the reoperation rate was 8.7%(4/46),and the long-term postoperative complication rate was 6.5%(3/46).ConclusionPTOBF combined with rigid choledochoscopic stenoplasty for benign hepatic duct strictures is a safe and feasible procedure to reduce the stone recurrence and long-term postoperative complications.
作者
叶永青
冯军
李恩泽
龚靖霖
王平
Ye Yongqing;Feng Jun;Li Enze;Gong Jinglin;Wang Ping(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2023年第7期528-532,共5页
Chinese Journal of Hepatobiliary Surgery
基金
广东省科技计划项目(2017ZC0222)
广州市科技计划项目(201803010065、202102010251)。
关键词
胆管
肝胆管狭窄
经皮经肝Ⅰ期胆道造瘘
临床疗效
Bile ducts
Hepatic bile duct stricture
Percutaneous transhepatic one step biliary fistulation
Clinical efficacy
