X线监视下激光碎石治疗难治性胆总管结石的效果研究

Fluoroscopy guided laser lithotripsy for difficult bile duct stones

目的 探讨X线监视下激光碎石治疗难治性胆总管结石的效果和安全性.方法 将40例难治性胆总管结石患者分为两组,分别在子镜监视下（子镜监视组,21例）及X线监视下（X线监视组,19例）进行激光碎石治疗,比较两组间结石取净率、并发症发生率.结果 子镜监视组共取净结石19例（90.5%）,X线监视组取净17例（89.5%）,两组间结石取净率差异无统计学意义（P=0.658） 两组间并发症发生率差异无统计学意义（19.0%比15.8% P=0.559）.结论 治疗难治性胆总管结石X线监视与子镜监视两种方法是同样安全有效.

Objective To evaluate the efficacy and safety of fluoroscopy guided frequency-doubled double-pulsed laser lithotripsy for removing difficult bile duct stones. Methods From March 2008 to December 2009, patients with difficult bile duct stones were divided into cholangioscopy guided group （ n = 21 ）and fluoroscopy guided group （ n = 19） to receive corresponding treatments. The success rate of complete stone removal and the complication rate related to the procedure were compared between the two groups.Results There are no significant differences between 2 groups in regarding of either success rate of complete stone removal （ 19/21, 90. 5% in cholangioscopy guided group vs. 17/19, 89. 5% in fluoroscopy guided group, P 〉0. 05 ） or rate of procedure related complication （4/21, 19. 0% in cholangioscopy guided group vs. 3/19, 15. 8% in fluoroscopic guided group, P = 0. 559 ）. Conclusion Frequency-doubled doublepulsed laser lithotripsy guided by cholangioscopy or fluoroscopy are both safe and effective.