胆道术后难取性残石的联合内镜治疗

Combined endoscopic treatment for postoperative refractory residual gallstones

目的 探讨对术后胆道难取性结石内镜治疗的新途径。方法 以输尿管硬镜气压弹道碎石联用纤维胆道镜治疗 2 8例巨大、嵌顿性胆道残石。结果 2 8例均经 1～ 3次取石取净结石 ,其中经 1次取净者 16例 ,2次取净者 10例 ,3次取净者 2例 ,无严重并发症发生。结论 本方法具有安全、高效、简便、作用直接、无热损伤、并发症少等优点 ,特别适用于巨大、嵌顿性结石 ,是治疗术后胆道难取性结石的新途径 ,临床应用前景广阔。

Objective To explore a new way of treating refractory residual gallstones by endoscopy. Methods Choledochfiberscope(CHF) combined with air pressure ballistic lithoclast(APBL) under ureterscopy were used on 28 cases of large or impacted residual gallstones. Results All refractory stones were crushed and extracted completely in 1 3 times, including sufficient once in 16, twice in 10 and thrice in 2. No severe complications were occurred in this series. Conclusions This procedure is a safe, effective, simplicity, less complication and no heat injury methods. It is proved to be a new way of treating refractory residual gallstones, especially for large or impacted lithiasis. It is worthy for clinical application widely in the future.