十二指肠镜下子母镜联合U-100激光治疗难治性胆总管结石的疗效

Duodenoscopic Mother-baby Scopy with U-100 Laser in Treatment of Refractory Choledocholithiasis

目的观察十二指肠镜下子母镜联合U-100双频激光治疗难治性胆总管结石的疗效,评估其应用价值。方法对39例结石直径大于2.0 cm以上、嵌顿性、多发结石无法经内镜下逆行胰胆管造影(ERCP)用网篮取出的难治性胆总管结石患者,行十二指肠镜下子母镜联合U-100激光碎石取石。结果全组均成功取石,其中行2次及以上ERCP的患者20例(51.3%)。无胆管损伤、出血、穿孔、坏死性胰腺炎等严重并发症发生。结论十二指肠镜下子母镜联合U-100激光碎石对于难治性胆总管结石患者的治疗是安全、有效的,但亦存在手术时间长、操作复杂、手术费用高等局限性。

Objective To observe the effect of duodenoscopic mother - baby scopy with U - 100 laser on refractory choledocholithiasis to evaluate its application value. Methods Duodenoscopic mother - baby scopy with U - 100 laser was used to remove the stones （incarcerated, multiple stones, 〈 2.0 cm in diameter） in 39 refractory choledocholithiasis patients, which failed to be taken out by endoscopic retrograde cholangiopancreatography （ERCP） and with stone baskets. Results Stones were successful to be removed in all patients, including those with 2 or more ERCPs （51.3%）. No such severe complications as bile duct injury, bleeding, perforation, necrotizing pancreatitis occurred. Conclusion Doudenoscopic mother - baby scopy with U -100 laser is safe and effective in treatment of refractory choledocholithiasis, but the operation lasts long, complex to operate with a higher cost, which is its limitation.