纤维胆道镜在复杂上尿路结石手术中的应用

Choledochofiberscope in ureterolithotomy of complex upper urinary tract calculi

目的 探讨纤维胆道镜在复杂上尿路结石手术中的应用价值。方法 将纤维胆道镜应用于输尿管多发结石、输尿管结石并肾结石以及输尿管结石移位的手术中 ,取出结石。结果 2 1例中 19例纤维胆道镜取石成功 (其中 1例有 2米粒大结石残留于肾盏内 ,出院后 2周内排出 ) ,2例失败后改行传统手术。结论 纤维胆道镜应用于复杂上尿路结石手术中 ,治疗效果较好、损伤小 ,是一种安全有效的方法 ,值得推广应用。对于用纤维胆道镜取石困难、估计损伤较大的病例 ,采用传统方法延长切口取石为宜。

Objective To evaluate the significance of choledochofiberscope in the surgical treatment of complex upper urinary tract calculi. Methods Twenty-one patients with complex upper urinary tract calculi (multiple ureteral calculi, ureteral calculi dislocation, ureteral combined renal calculi) underwent ureterlithotomy and stones were removed. Results Nineteen patients successfully underwent the operation. Among them 1 patient had two 3-mm residual fragments in the renal calyces and excreted them 2 weeks after discharge from hospital. Two cases failed after being treated with cholechofiberscope, and then traditional operation was performed. Conclusion It is a safe and reliable method to treat complex upper urinary tract calculi with ureterolithotomy and choledochofiberscopy. To those who have difficulty in having stones removed by choledochofiberscope, traditional operation with enlarged incision is an appropriate choice.