胆道镜配合钬激光术中治疗难取性胆管结石的临床应用体会

The treatment of refractory bile duct stones by choledochoscope combined with holmium laser

目的探讨胆道开放手术中经胆道镜配合钬激光治疗难取性肝内胆管结石的方法、疗效及安全性。方法 56例难取性肝内胆管结石采取经胆道镜配合钬激光碎石治疗。结果 53例一次性完全清除;3例碎石未能一次性完全清除结石,需再用切肝或胆管切开取石。一次性清除率为94.6%。全组病例未发生胆道损伤出血、胆漏、感染等并发症。结论术中胆道镜配合钬激光碎石是治疗肝内胆管难取性结石的一种安全、有效的技术。

Objective To illuminate the method, efficacy and safety of refractory intrahepatic bile duct stones treated by choledochoscope combined with holmium laser lithotripsy in open biliary surgery. Methods Fifty-six cases of refractory intrahepatic biliary stones treated by choledochoscope combined with holmium laser lithotripsy were retrospectively analyzed. Results In all the 56 cases, 3 cases received primary complete removal of stones, and in the remaining 3 cases, stones were not completely removed once and hepatectomy or choledochotomy was performed. One-time clearance rate was 94. 6% . All the patients had no bile duct injury bleeding,bile leakage and infection. Conclusion It is a safe and effective new procedure for treatment of refractory intrahepatic bile duct stones by choledochoscope combined with holmium laser lithotripsy.