硬性胆道镜下胆囊结石(或息肉)保胆手术200例临床研究

Clincal study on effect of 200 patients cholelithiasis-cholecystolithiasis (polypus) to conservative gallbladder operation by rigid choledochoscope

目的探讨胆囊结石及胆囊息肉经硬性胆道镜下微创保胆取石(或息肉)手术的适应证以及预防结石术后复发。方法采用WOLF新式硬性胆道镜完成保胆取石手术200例,其中2例急性胆囊炎、8例萎缩性胆囊炎均行保胆取石术,利用气压弹道碎石技术13例,45例采取腔内电凝导丝电凝止血。保胆取石术后患者常规服用步长胆石利通片,防止胆汁胆固醇饱和,防止结石复发。结果 200例患者平均手术时间(55±5)min、平均住院时间5d,其中放置胆囊造瘘管9例。除1例保胆失败最终选择切胆手术、3例保胆取石术后发现胆囊内沉积物外,其余患者均获得近期较为理想的疗效。结论硬性胆道镜下微创保胆取石(息肉)手术安全、可行、疗效满意。

【Objective】To evaluate the indication of cholelithiasischolecystolithiasis or polypus by rigid choledochoscope to conservative gallbladder operation and prevent lithiasis recurrence after operation.【Methods】To complete 200 patients of conservative gallbladder operation by new types of WOLF rigid choledochoscope,among them 2 patients of acute cholecystitis and 8 patients of atrophic cholecystitis all to conservative gallbladder operation,13 patients by air-pressure trajectory lithotrity,45 patients by intracavitary electrocoagulation.The patients after conservative gallbladder operation routine oral Buchang Danshi Litong tablet,prevent bile and cholesterin saturation,prevent lithiasis recurrence.【Results】The average operation time of 200 patients was （55 ± 5） minutes,the average time of hospitalization was 5 days,among them 9 patients of cholelithiasis fistula,1 patients to choose cholecystectomy because of conservative gallbladder operation failure,3 patients to discover deposition into cholelithiasis after conservative gallbladder operation,The rest patients all acquire ideal curative effect in the near future.【Conclusions】 Cholelithiasis-cholecystolithiasis （polypus） to conservative gallbladder operation by rigid choledochoscope is an effective and safe method with good clinical results.