气压腔内弹道碎石术治疗胆道术后难取性残留结石

APBL treatment for postoperative refractory residual gallstones

目的了解气压腔内弹道碎石(即APBL)术在胆道术后难取性残留结石的治疗效果.方法通过纤维胆道镜和输尿管硬镜配合下,应用国产的气压腔内弹道碎石机对15例胆道术后残留的铸型的,直径大于1.5cm,或嵌顿的,难取性结石采用碎石后再取石,检验APBL在治疗胆道术后难取性残留结石的可行性.结果15例患者除1例好转后放弃治疗外,余14例均经1～3次APBL后取石干净治愈出院,无严重并发症,治愈率达93.3%.结论APBL在治疗胆道术后残留结石中只要应用合理是一种安全,高效,低廉的碎石方法,可大大提高胆道术后残留结石的治愈率和避免因取石造成的胆道损伤,特别适用于不是处于胆道弯曲位的巨大的,胆管狭窄口上端的,铸型的,或嵌顿性等原因造成的难取性结石.

Objective: To investingating the treating effect of air pressure ballistic lithocast(APBL) on postoperative refractory residual gallstones. Methods: domestical APBL machines cooperated with choledochfiberscope under ureterscopy were used to crush and extract postoperative refractory stones on 15 cases of cast,larger than 1.5 cm in diameter, impacted residual gallstones. To check the feasibility in treating postoperative refractory residual gallstones by APBL. Results: Except that one gave up treatment after getting better, all refractory stones of 14 cases were extracted completely in 1~3 times.No severe complications were occurred in this series. Conclusions: APBL treatment for postoperative refractory residual gallstones is a safe, effective and cheap method. It can greatly increase the curing rates of postoperative refractory residual gallstones and aviod the injury on bile and duct caused by extracting stones, especially for not located in crooked place, large, upper narrow opening of bile and duct,cast or impacted residual gallstones.