胆道镜下微爆破技术处理肝内外胆管嵌顿性结石的临床分析

Mini-blasting lithotripsy treating incarcerated intra-and extrahepatic bile duct calculi under choledochoscopy

目的:探讨胆道镜下微爆破碎石术处理肝内外胆管嵌顿性结石的手术方法。方法:回顾分析2008年6月至2010年6月采用iMES-I型体内微爆破碎石仪治疗肝内外胆管嵌顿性结石43例患者的临床资料,分析碎石成功率、结石取净率及并发症发生率。结果:43例患者均碎石成功,成功率100%;术中一次性结石取净率83.7%,术后二次碎石、取石成功率100%。无胆道损伤、穿孔、出血、胆漏等严重并发症发生。结论:胆道镜下微爆破碎石术治疗胆道内嵌顿性难取性结石操作简单,安全易行,疗效确切,明显提高了结石取净率。

Objective：To discuss the operative method of mini-blasting lithotripsy treating incarcerated intra-and extrahepatic bile duct calculi under choledochoscopy.Methods：Clinical data of 43 patients using iMES-I mini-blasting lithotrite to treat incarcerated intra-and extrahepatic bile duct calculi from Jun.2008 to Jun.2010 were retrospectively analyzed.The successful rate of lithotripsy,clearance rate of calculi and complication were discussed.Results：The successful rate of litrotripsy was 100%.One stage clearance rate was 83.7% and successful rate of lithotripsy and calculi removal after second mini-blasting was 100%.No complications such as bile duct injury,perforation,hemorrhage or bile leakage occurred.Conclusions：Mini-blasting lithotripsy under choledochoscopy is a safe,easy and effective method to treat incarcerated intra-and extrahepatic bile duct calculi.This procedure obviously increases clearance rate of calculi.