电子胆管镜治疗肝胆管手术后残留结石临床分析

Clinical analysis of electronic cholangioscopy in treating residual stone after hepatic bile duct surgery

目的:探讨电子胆管镜在肝胆管术后残留结石治疗中的临床应用效果。方法:回顾性分析2008年6月～2010年6月我院应用电子胆管镜治疗术后胆管残余结石167例,采用"循洞而进,见石即取,先易后难,化整为散"的原则进行操作。结果:98例1次取净全部结石,31例2次取净结石,38例3次以上取石。4例未完全取净,结石取净率达97.0%。术后出现发热37例,腹泻21例,T管放置不到位7例,胆管出血7例,窦道破裂致胆汁腹膜炎1例。结论:电子胆管镜治疗肝胆管术后残留结石,可明显降低残石率及再手术率。

Objective：To analyze the application effect of electronic cholangioscopy in treating residual stone after hepatic bile duct surgery.Methods：167 patients with postoperative residual stone in bile duct were treated through electronic cholangioscopy in our hospital from June 2008 to June 2010.The postoperative data were collected and retrospectively analyzed.Results：Stones were cleaned in 98 cases by only once procedure,31 cases by twice procedures and 38 cases by more than three times procedures.The whole stone clearance rate was 97.0%.73 cases had postoperative complications including fever（37 cases）,diarrhea（21 cases）,improper locating of T-tube（7 cases）,hemobilia（7 cases） and bile peritonitis caused by sinus rupture（1 cases）.Conclusion：Electronic cholangioscopy for treating postoperative residual stones could decrease the residual stone rate and reoperation rate.