纤维胆道镜联合钬激光碎石治疗术后难取性胆管残留结石

Clinical Application of Holmium Laser Combined with Choledochoscope for Treatment of Refractory Intrahepatic and Extrahepatic Bile Duct Stones

目的总结经胆道镜联合钬激光碎石治疗术后难取性胆管残留结石的经验,探讨其效果和安全性。方法回顾性分析术后胆管残石患者108例,其中单发结石48例,多发结石60例,经纤维胆道镜导入激光光纤,光纤直径230μm。之后采用能量800～1 200 mJ,频率8 Hz,功率6.4～9.6 W的钬激光碎石取石治疗。术后随访6～12个月。结果经过1～7次胆道镜下钬激光碎石治疗,108例患者术后胆管残留结石全部取出,未出现胆道出血、胆漏、感染等明显并发症;随访6～12个月,87%患者无结石复发。结论经胆道镜钬激光碎石术是目前治疗术后胆管难取性残留结石的一种安全、有效的方法。

Objective To investigate the practicability and safety of holmium laser combined with choledochoscope for treatment of refractory posto- perate bile duct stones. Methods 108 patients with refractory postoperative bile duct stones underwent treatment of holmium laser combined with choledocho- scope. The clinical and follow-up results were reviewed. Results All patients were cured after one to seven times of the treatment. No recent complications and no palindromia stones. Conclusions Holmium laser combined with cholodochoscope is a safe and practicable method in the treatment of refractory postopera- tive bile duct stones.