经皮经肝胆管引流术注药溶石联合体外冲击波碎石术治疗肝外胆管结石32例报告

Treatment of extrahepatic cholelithiasis by ESWL and dissolvent through PTCD

目的探讨碎石、溶石联合治疗肝外胆管结石的疗效。方法对３２例肝外胆管结石行经皮经肝胆管引流术，碎石、溶石和冲洗治疗，直至结石消失。结果本组结石３２例全部消失。其中１次碎石３０例，２次碎石２例。注射辛酸甘油酯溶石，其中用药１次１９例，２次７例，３次６例。结论经皮经肝胆管引流术（ｐｅｒｃｕｔａｎｅｏｕｓｔｒａｎｓｈｅｐａｔｉｃｃｈｏｌａｎｇｉａｌｄｒａｉｎａｇｅ，ＰＴＣＤ）注药溶石联合体外冲击波碎石术（ｅｘｔｒａｃｏｒｐｏｒｅａｌｓｈｏｃｋｗａｖｅｌｉｔｈｏｔｒｉｐｓｙ，ＥＳＷＬ）治疗肝外胆管结石安全有效，适用于年老体弱、不能耐受手术者。

Objective To evaluate the effect of extracorporeal shock wave lithotripsy (ESWL) combined with stone dissolvent infusion through (PTCD) on extraheptic bile duct stones.Methods Thirty two patients with extrahepatic cholelithiasis were treated by ESWL followed by stone dissolvent infusion through the catheter of percutaneous transhepatic cholangiography and drainage (PTCD).Results The extraheptic bile duct stones of the 32 patients all disappeared after the procedure.The stones of 30 cases were smashed by one session of ESWL,and stones of 2 cases by 2 sessions,and smashed stones were totally dissolved and removed by infusion of glyceride caprylate for 1 to 3 sessions.Conclusions It is safe and efficient to treat extrahepatic cholelithiasis by this modality especially for elderly and those with poor risk for open surgery.