摘要
目的探讨胆道镜在难治性胆道残余结石的治疗。方法行胆总管切开取石、T管引流术后的肝内外胆管残余结石患者120例,其中30例为复杂性肝内胆管残余结石,对其临床资料作回顾性分析。结果取石难度较大的主要原因有结石因素和胆管因素;其中结石因素11例,胆道因素19例,其中12例存在肝内胆管狭窄,3例合并胆管的汇流异常或胆管变异;4例结石所在胆管与其汇入的胆管呈锐角。经肝胆B超或CT证实胆管残余结石,再次行胆道镜检查和(或)结合术中胆道镜超选造影,成功发现残余结石,经胆管扩张、液电碎石及取石等措施将残余结石取净,无残留结石发生。结论肝内胆管残余结石难治性的原因复杂,针对不同原因采用不同的方法。结合胆道镜超选造影、胆管扩张、液电碎石可提高取石成功率。
Objective To evaluate the therapeutic effect of fiber choledochescope on refractory residual bile duet stones.Methods The clinical datas of 120 cases with common bile duct exploration and T tube drainage in our hospital,including 30 cases of refractory intrahepatic bile duct residual stones,its clinical data were analyzed retrospectively. Results The main reason on refractory residual there were stones and bile duct factors,among which,11 cases were stone factors,19 cases were biliary tract factors,including 12 cases with intrahepatic bile duct stenosis,the confluence of three cases with biliary abnormalities or bile duct variation; 4 cases of bile duct stones where the bile duct and its import is a sharp angle. After Bile duct residual stones were confirmed by CT and B ultrasound,the residual stones were successfully found in the patients though choledochoscopy and( or) super selective angiography. After bile duct dilatation,liquid electric lithotripsy and stone removal,residual stones were removed,and no residual stones occurred.Conclusion Complex for the reason of the treatment of residual stones in the intrahepatic bile duct,Adopt different methods for different reasons. The success rate of stone was improved by choledochoscopy super selective angiography,bile duct dilatation and liquid electric lithotripsy.
出处
《肝胆外科杂志》
2015年第5期341-343,共3页
Journal of Hepatobiliary Surgery
基金
合肥市医学重点学科建设计划资助
关键词
胆道镜检查
肝胆管结石病
肝内胆管狭窄
碎石
Choledochoscopy
Hepatolithiasis
Intrahepatic duct strictures
lithotripsy
