术后胆道镜取石1226例体会

Experience of Calculi extraction by choledochoscope Postoperatively in 1226 cases

目的探讨经T管窦道胆道镜取石的方法及技巧,评价胆道镜在肝内外胆管结石治疗中的价值。方法回顾分析我院1990年3月至2011年9月术后胆道镜取石1226例,结石取净后常规行T管造影。结果共取石2685次,平均2.2次,取石最多次数者为12次。取净1182例,取净率96.4%。除1例为了重新放置T管而扩张窦道时引起出血、2例取石过程中引起窦道破裂外,未发生其它严重并发症。结论术后胆道镜取石,作为胆道结石特别是肝胆管结石治疗环节中不可或缺的一环,在胆道结石治疗中扮演着十分重要的角色。

Objective To explore the methods and skills of calculi extraction by choledochoscope through the T-tube sinus tract,and to estimate the value of choledochoscopy in treatment for intrahepatic and extrahepatic bile duct stones.Methods The data of 1226 patients with intrahepatic and/or extrahepatic bile duct stones from March 1990 to September 2011 were retrospectively analyzed.T-tube cholangiography was carried out in each case after completely removing stones.Results 2685 times of calculi extraction were performed,with the average times of 2.2 in each case,and the largest number of performing times was 12.Bile duct stones were removed thoroughly in 1182 cases,with the stone clearance rate of 96.4%.There were no other severe complications except for hemorrhage in one case when dilating the sinus tract for replacing T-tube,and sinus tract rupture in two cases when extracting stones.Conclusion As an indispensable link for the treatment of bile duct stones,especially of intrahepatic bile duct stones,postoperative calculi extraction by choledochoscope plays an important role in the treatment of bile duct stones.