胆道镜定向微爆破碎石术在胆囊管结石保胆取石中的应用

Choledochoscope directed gallbladder-preserving micro-blasting lithotripsy for cystic duct calculus

目的：探讨胆道镜定向微爆破碎石术用于胆囊管结石患者保胆取石术的安全性及可行性。方法：采用体内微爆破碎石仪在纤维胆道镜直视下为21例胆囊管结石患者定向碎石。结果：21例平均碎石1~3次,平均取石时间5~10m in;除1例因碎石次数较多,胆囊管水肿放置胆囊引流管,2周后拔除外,余均一期缝合胆囊壁,术后无胆囊炎、胆漏等并发症发生,无中转胆囊切除术者。结论：纤维胆道镜直视下为胆囊管结石患者行体内微爆破定向碎石术安全、有效。

Objective：To investigate the security and feasibility of choledochoscope directed gallbladder-preserving micro-blasting lithotripsy for patients with cystic duct calculus.Methods：In vivo micro-blasting lithotripsy under direct choledochofiberscopic vision was performed in 21 patients with cystic duct calculus.Results：Twenty-one patients underwent lithotripsy 1-3 times,the mean time was 5-10min.Drainage tube was put in gallbladder for 1 patient because of too many times of lithotripsy and bile duct edema.The tube was removed 2 weeks later.The cystic wall was primarily sutured in the other patients.No postoperative complications such as cholecystitis or bile leakage occurred.No cases were converted to cholecystectomy.Conclusions：In vivo micro-blasting lithotripsy under direct choledochofiberscopic vision is safe and effective for patients with cystic duct calculi.