经内镜治疗复发性化脓性胆管炎合并的总胆管结石

Endoscopic Removal of Large Common Bile Duct Stones in Recurrent Pyogenic Cholangitis

在化脓性胆管炎患者发现较大结石梗阻胆管情况并非少见.一组291例胆管炎患者中,32例有直径大于2cm的结石。内镜下联合运用大篮形钳,1％依地酸(EDTA)冲洗和手工或机械碎石可使50％患者胆管内结石清除干净.结石嵌顿总胆管而使取石钳无法张开是失败的主要原因。

It is not uncommon to find large stones obstructing the bile duct in patients with recurrent pyogenic cholangitis.In a series of 291 patients with cholan- gitis, 32 patients had stones more than 2 cm in diameter. Endoscopic extraction using a combination of large baskets,1% EDTA flushing,and manual or mechanical lithotripsy allowed the common bile duct to be cleared in 50% of patients. Lack of space in the common bile duct to open the retrieval basket because of stone impac- tion was the major reason for failure.