电视输尿管硬镜治疗胆道术后残石

THE USE OF VIDEO-URETEROSCOPE IN THE TREATMENT OF POSTOPERATIVERESIDUALSTONESOFBLIARYTRACT

近１年来，我院采用电视输尿管硬镜经Ｔ管窦道用５种取石方法清除胆道术后残余结石２６例，部分病人结合使用纤维胆道镜治疗，效果满意。痊愈２５例，好转１例，无并发症，治愈率达９６％。这项技术尚未见报道。该五种镜下取石技术包括：①用取石钳直接将结石钳出；②用网篮将石套出；③对于泥沙样的碎石或取石钳咬碎后的结石用注射器直接从输尿管镜进行“冲、吸”取石；④胆管狭窄时，可用取石钳扩张或用气囊导管扩张后取石；⑤对较大的结石，并有嵌顿时可用张宝善的“胆石开窗碎石术”或直接用腔内弹道气压碎石机进行弹道碎石，然后取出结石。

n the recent one vear, video-ureteroscope was used to treat postoperativeresidual stones of the biliary tract through sinus tract of“T”tube in 26 cases inour hospital. 25 cases were cured and the major part of biliary stones was elimi-nated in another one.There was no failure. The techniques of“taking-biliarystones”included:①Clamping stone with clamp;②Netting stone with netbaskettechnique;③Irrigation and suction approach with saline for sandlike stones;④ Dilating stenosed biliary duct by catheterization with balloon followed by elimi-nating stone;⑤ Lithotresis or/and lithotripsy in large stone before eliminating.