胆道镜下液电碎石术联合B超治疗肝内胆管残留结石的体会

Experience of postoperative choledochoscopic electrohydraulic lithotomy combined with ultrasound in treatment of retained hepatolithiasis

目的探讨胆道镜下液电碎石术联合B超治疗胆道术后残留结石临床价值和疗效。方法将82例术后肝内胆管残留结石患者分为两组,胆道镜辅以术中B超经T管窦道液电碎石取石治疗肝内胆管术后残石42例为治疗组,以胆道镜取石40例患者为对照组。结果治疗组结石取净率显著高于对照组(P<0.05),平均手术时间、手术次数、住院时间和平均住院费用等明显优于对照组(P均<0.05)。两组患者手术后均无严重并发症。结论胆道镜下液电碎石术联合术中B超治疗术后肝内胆管残留结石,具有定位准确、创伤小、安全有效、可重复操作等优点,值得临床推广使用。

Objective To explore clinical value and effect of postoperative choledochoscopic electrohydraulic lithotomy combined with ultrasound in treatment of retained hepatolithiasis. Methods 82 cases with postoperative retained hepatolithiasis were divided into two groups. Choledochoscopic electrohydraulic lithotomy combined with ultrasound via T-tube sinus was applied to treat 42 cases which was served as therapeutic group（TG）. Choledochoscopy via T tube sinus was applied to treat 40 cases which was served as control group （CG）. Results The TG was much superior to the CG in the removed caculi rate （P〈0.05）. The average operative time, operative times,hospitalization in the TG were less than that CG.There were no serious postoperative complicatioins in two groups. Conclusion Choledochoscopic electrohydraulic lithotomy combined with ultrasound possesses localized accuracy,less trauma, safety, effectiveness and repeatable manipulation etc advantages in the treatment of postoperative retained hepatolithiasis.