术中应用胆道镜对肝内胆管结石治疗的临床效果观察

Observation on the Effect of Intraoperative Choledochoscopy in the Treatment of Intrahepatic Bile Duct Cholelithiasis

目的探讨术中应用纤维胆道镜在肝内胆管结石治疗方面的临床疗效与应用价值。方法选取2009年9月至2011年11月来我院就诊治疗的93例肝内胆管结石患者随机分为胆道镜手术组(45例)和传统手术组(48例),对比两组患者的临床治疗资料。结果胆道镜组术后观察优良患者41例,差4例,优良率91.11%(41/45);传统手术组术后患者优良37例,差11例,优良率77.08%(37/48)。胆道镜组术后残留结石患者胆道镜组3例,残留结石率6.67%(3/45),传统手术组残留结石患者9例,残留结石率18.75%(9/48)。术后并发症,胆道镜组4例,并发症率8.89%(4/45),传统手术组11例,并发症率22.92%(11/48),两组差异有统计学意义(P<0.05)。结论术中应用纤维胆道镜治疗肝内胆管结石的手术优良率高、术后残留结石率低、并发症少,值得广泛应用于临床。

Objective To explore the clinical effect and application value of intraoperative choledochofiberscope in the treatment of intrahepatic bile duct cholelithiasis. Methods 93 patients with intrahepatic bile duct cholelithiasis in our hospital from September 2009 November 2011 were randomly divided into the choledochoscope group （45 cases） and conventional surgery group （48 cases）. The clinical treatment data were compared between two groups. Results The excellent and good rate was 91.11% （41/45） in the choledochoscope group with 41 cases of excellent and good, and 4 cases of poor. The excellent and good rate was 77.08% （37/48） in the conventional surgery group with 37 cases of excellent and good, and 11 cases of poor. 3 cases had postoperative residual stones in the choledochoscope group with the residual stone rate of 6.67% （3/45）, and 9 cases had postoperative residual stones in the conventional surgery group with the residual stone rate of 18.75% （9/48）. 4 cases had complications in the choledochoscope group with the complication rate of 8.89% （4/45）, and 11 cases had complications in the conventional surgery group with the complication rate of 22.92% （11/48）, and the difference between two groups was statistically significant （P 〈0.05）. Conclusions Intraoperative choledochofiberscope using in the surgery of intrahepatic bile duct cholelithiasis has high excellent and good rate, low postoperative residual stones rate, and less complications, which is worthy of clinical application.