纤维胆道镜联合钬激光治疗肝胆管结石的体会

Experience of Clinical Treatment on Intrahepatic and Extrahepatic Stones with Fiber Choledochoscope and Holmium Laser

目的总结分析纤维胆道镜联合钬激光治疗肝胆管结石的临床经验。方法 2009年1月至2013年6月,肝内外胆管结石76例,采用纤维胆道镜联合钬激光治疗。结果 76例患者手术均取石成功。术后并发症9例,其中切口感染4例,肺部感染3例,胆漏2例,均治愈。术后随访6个月至3年,平均17个月,经B超或"T"管造影检查,未发现结石复发、残留及胆管狭窄。结论纤维胆道镜联合钬激光治疗肝胆管结石具有创伤小、并发症少、取石率高、残石率低等优点,可同时发现并处理胆管狭窄。

Objective To summarize and analyze the clinical experience of joint treatment on intrahepatic and extrahepatic stones with fiber choledoehoscope and holmium laser. Methods The elirlical datum of 76 patients suffered from intrahepatie and extrahepatic bile stones and given combined treatment of fi- ber eholedoehoscope and holmium laser in our hospital from Jan 2009 to Jun 2013 was collected. The diameters of the stones ranged from 3 mm to 15 mm. Among these patients, 29 had incarcerated stones, 17 east form stones, 30 free type stones, and 27 intrahepatic bile duet stenosis （22 of them with membranous stenosis, and 5 with tubular stenosis）. Results The stones were successfully removed in all the 76 eases. Complications occurred in 9 cases in total, all cured： incisional