经十二指肠镜治疗左右肝管结石的疗效观察

The efficacy of treatment the left-right hepatic ducts stone with duodenoscope

目的探讨经十二指肠镜技术微创治疗左右肝管结石的临床意义。方法 86例确诊为左右肝管结石伴或不伴胆总管结石的患者应用十二指肠镜治疗性ERCP技术行胆总管取石后再行左右肝管取石治疗,观察成功率、并发症发生情况。结果 86例患者81例一次治疗成功,成功率94.1%,所有患者无出血、穿孔及重症胰腺炎发生,12例伴有高淀粉酶血症经禁食抑制胰液分泌治疗2～3d恢复。结论左右肝管结石经十二指肠镜微创治疗是一种创伤小、安全,有效的治疗方法。

Objective To discuss the clinical significance of minimally invasive treatment on the left-right hepatic ducts stone with duodenoscope.Methods Observed the success rate and the complications of the treatment on the 86 patients,who had been diagnosed as having left-right hepatic ducts stone with or without common bile duct stones,that dislodge the common bile duct stones before dislodge the left-right hepatic ducts stone by application of therapeutic ERCP techniques with duodenoscope.Results 81 cases of the 86 patients have been cured by one-time treatment,and the success rate was 94.1%.All patients had no bleeding,perforation,and severe pancreatitis.12 cases associated with hyperamylasemia had been cured after 2 or 3 days treatment by absolute diet to inhibition the pancreas secretion.Conclusion The results show that the minimally invasive treatment with duodenoscope on the patients with left-right hepatic duct stones has the features with small wounds,safe and effective.