术中B超联合纤维胆道镜在肝胆管结石手术治疗中的应用

The treatment of hepatolithiasis with intraoperative ultrasound combined with choledochoscope

目的探讨术中B超联合纤维胆道镜在肝胆管结石手术治疗中的临床应用价值。方法回顾性总结分析我院2013年1月-2013年12月收治的44例较复杂肝胆管结石患者在手术中应用B超联合纤维胆道镜进行外科治疗。结果术后无胆漏、腹腔出血及肝功能衰竭等并发症发生;无死亡病例,均治愈出院。术后8周常规行T管造影或B超复查,发现胆管残余结石2例,采用经T管窦道胆道镜检查,使用纤维胆道镜配合网篮取出残余结石。结论术中B超配合纤维胆道镜可以降低传统经胆总管切开取石的盲目性,有效减少术后结石的残留,在治疗肝胆管结石疾病上有重要的临床推广价值。

[ Objective ] To assess the effectiveness of the intraoperative ultrasound and choledochoscope whichwere applied in the surgical treatment of hepatolithiasis. [ Methods ] The outcomes of 44 cases with hepatolithiasiswho were treated by the intraoperative ultrasound and choledochoscope in the operation were retrospectively ana-lyzed. [ Results ] The complications of bile leak, abdominal hemorrhage and hepatic failure didn＇t occurred postop-eration. No death occurred. T-tube cholangiography and B ultrasound were performed after 8 weeks. 2 cases had oc-curred residual calculus. These cases were treated by the choledochoscope and the residual calculus were extractedby the basket. [ Conclusion ] The blindness of the traditional surgical treatment as the lithotomy could be reduced byapplying the intraoperative ultrasound and choledochoscope in the operation. The occurrence of residual biliary cal-culus would be decreased significantly, and the value of this surgical technology would become important in the clin-ical treatment.