胆道镜诊治肝内外胆管残余结石3615例分析

An analysis of 3615 cases with residual bile duct stones undergoing postoperative choledochoscopy

目的探讨胆道镜诊治术后肝内外胆管残余结石的疗效。方法回顾性分析胆道镜诊治肝内外胆管残余结石病例资料。结果 3615例患者术后残石率为31.31%(1131/3615)。胆道造影灵敏度为94%,特异度为85%。1115例胆道镜下经窦道取石1896次,手术时间(24.2±13.4)min,碎石212例,并发症率为5.3%,残石率0.36%。前期窦道未形成率高于中、后期病例(P<0.05)。结论胆道镜诊治胆管残余结石安全、高效。

Objective To investigate the outcomes of postoperative choledochoscopy for diagnosis and treatment of residual bile duct stones.Methods Data of 3615 cases underwent postoperative choledochoscopy for diagnosis and treatment of residual bile duct stones were analyzed retrospectively.Results A total of 1131（31.31%） cases had residual bile duct stones.The sensitivity of cholangiography was 94% and specificity was 85%.A total of 1115 cases with residual bile duct stones was treated by choledochoscopy for 1896 times with mean operative time of（24.2±13.4） min,in which 212 cases underwent lithotrity with an incidence of residual stones of 0.36% and an incidence of complications of 5.3%.The rate of unformed sinus was higher in the cases in the ealy stage than that those in the middle or late stage（P0.05）.Conclusion Postoperative choledochoscopy is a safe and highly efficient method for the diagnosis and treatment of residual bile duct stones.