应用纤维胆道镜术中取石60例临床分析

Analysis on 60 Cases Intraoperative Calculus Removing with Fibercholedochoscope

目的:探讨纤维胆道镜术中取石的治疗效果和经验。方法:对2008年1月至2010年1月间在我院住院治疗的胆管结石患者60例采取纤维胆道镜取石治疗,总结治疗效果和经验。结果:本组完全取净结石54例(90.00%),基本取净结石5例(8.33%),取石失败1例(1.67%)。1例壶腹部肿瘤经胆道镜检查获得了确诊并行胰十二指肠切除术。经T管造影、B超证实有4例(6.67%)残留结石,其中3例位于肝内胆管,1例位于胆总管,全部胆管残石患者均经T管窦道实施胆道镜取石,经1-4次胆道镜取石后结石全部取净。随访3-6个月,未发现胆道残余结石、胆道狭窄等并发症。结论:纤维胆道镜术中取石是治疗胆道结石的较好方法,具有操作简便、用时短、损伤轻、病人痛苦小、可以避免再次或多次胆道手术的优点,值得应用。

Objective： To investigate the effect and experience intraoperative calculus removing of treating cases with calculus of bile duct.Method： The 60 cases with calculus of bile duct in our hospital from January in 2008 to January in 2010 were treated by fibercholedochoscope,the effect and experience were summarized.Result： There were 54 cases（90.00%）with calculus removing fully,5 cases（8.33%） with calculus removing fundamentally and 1 case（1.67%） with calculus removing failure.One case with periampullary tumor was diagnosed finally and received the pancreaticoduodenectomy.There were 4 cases（6.67%） with residual stone certified by T tube opacification and B ultrasound,and residual stone of 3 cases located in intrahepatic bile ducts and residual stone of 1 case located in common bile duct.All of residual stone were removed by fibercholedochoscope in 1 to 4 times and all were removed out.There was no residual stone and biliary tract stenosis found.Conclusion： The calculus removing with fibercholedochoscope is an ideal way to treat the biliary calculi,and its advantage is convenient,short time,slight injuries,little distress and can avoid the second operation,so they are worth being used.