拔T管取石治疗胆道残留结石的体会

Experience of removal of a T-tube to extract stone for treating residual biliary duct stone

目的 :探讨拔T管取石治疗胆道残留结石的临床应用。方法 :对 1998年 3月～ 2 0 0 0年 8月间 5例胆道残留结石治疗的临床资料作回顾性分析。结果 :5例病人进行T管造影证实胆总管残留结石 ,其中结石在T管口 1例 ,T管口略上 1例 ,T管口下部 2例 ,左肝管口 1例。位T管口处结石可在拔T管时随T管带出 ,余例均在T管造影透视下经T管插入网套将结石移至T管内口 ,再拔T管将结石带出 ,其中 1例通过ERCP用导管将结石推至T管口处 ,再借助网套拔管取石。结论 :拔T管取石治疗胆道残留结石方法简单 ,可靠性大 ,可避免二次手术。

Objective: To investigate the clinical application of removal a T-tube for treating residual biliary duct stone. Methods: Retrospective analysis of treatment of residual biliary duct stone was made in 5 patients from Mar.1998 to Aug.2000. Results: The residual stone of common bile duct (CBD) was found under cholangiography in 5 patients undergoing bile duct surgery. Among them, the stone located in the opening of T-tube in 1 case, slightly above it in 1, below it in 2 and the opening of left hepatic duct in 1. The first one was extracted with removal of a T-tube. For the rest, after netbasket or catheter was inserted through T-tube or ERCP and then removed tone into T-tube opening, then as did. Conclusion: Using removal of a T-tube to extract stone is a simple, reliable way to treat residual biliary duct stone, with avoiding second operation.