胆道镜在肝胆管结石治疗中的应用研究

Application study of choledochoscope in the treatment of hepatolithiasis

目的探讨胆道镜在肝胆管结石术中、术后检查和治疗的应用价值。方法对我院1987年12月—2009年12月诊治的3 997例实施术中、术后胆道镜检查和治疗患者的临床资料进行回顾性分析。结果 3 997例中,手术治疗3 559例,门诊治疗438例。术中器械取石后总残余结石率54.0%(1 921/3 559),胆道镜技术术中应用后总残余结石率9.2%(328/3 559),术后胆道镜应用后总残石率3.2%(114/3 559),再手术率2.2%(78/3 559),未发生胆道镜相关并发症。结论胆道镜在肝胆管结石治疗中的作用显著,具有极高的临床应用价值,应作为肝胆管结石治疗的常规技术。

Objective To discuss the application value of choledochoscope in the inspection and treatment of prompt operation and post-operation of hepatolithiasis.Methods Clinical data of 3997cases who had choledochoscope inspection and treatment in prompt operation and post-operation of hepatolithiasis in our hospital from December 1987 to December 2009 were retrospective analyzed.Results In these 3997cases,3559 cases take operation treatment and the rest 438 take outpatient treatment.The general residual stone rate is 54.0%（1921/3559） after extraction of bile duct stones during the operation by instruments;when choledochoscope technique during the prompt operation has been adopted,it reduces to 9.2%（328/3559）;after the application of choledochoscope technique in post-operation,only 3.2%（114/3559）of patients have residual bile duct stone.2.2%（78/3559） of patients received the operation again and no complications related to choledochoscope occurred.Conclusion With a significant effect on the hepatolithiasis treatment and great clinical value,choledochoscope should be considered as one of the routine techniques in the treatment of hepatolithiasis.