术中B超联合纤维胆道镜在肝胆管结石手术治疗的应用

Application of intraoperative B ultrasound combined with fiber choledochoscope in hepatolith operation treatment

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 50例较复杂肝胆管结石患者,随机分为实验组和对照组,各25例。实验组患者在进行手术中应用B超联合纤维胆道镜进行外科治疗,对照组患者采用常规手术治疗方式。观察两组疗效。结果实验组总有效率为96%,高于对照组的60%,差异有统计学意义(P<0.05);实验组残石复发率为4%,低于对照组的24%,差异有统计学意义(P<0.05)。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,有利于正确选择手术方式,既可有效地降低术后残石率,又能减少手术创伤;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情况,直接关系到肝内胆管结石最终残石率,应常规使用。该方法效果明显疗效显著,在治疗肝胆管结石疾病上有重要的临床推广价值。

Objective To investigate clinical application value of intraoperative B ultrasound combined with fiber choledochoscope in hepatolith operation treatment. Methods A total of 50 patients with complex hepatolith were randomly divided into experimental group and control group, with 25 cases in each group. The experimental group received intraoperative B ultrasound combined with fiber choledochoscope for surgical therapy. The control group received conventional operation for treatment. Curative effects of the two groups were observed. Results The total effective rate of the experimental group was 96%, which was higher than 60% of the control group, and their difference had statistical significance（P〈0.05）. The experimental group had lower recurrence rate of residual cholelith as 4% than 24% of the control group, and the difference had statistical significance（P〈0.05）. Conclusion Combination of intraoperative B ultrasound and fiber choledochoscope can effectively reduce blindness brought by conventional choledochotomy and postoperative residual cholelith. This method is helpful for correct operation method choice, reducing postoperative residual cholelith rate, and operation trauma. Its application in hepatolith surgery is directly related with residual cholelith rate, and it should be applied as general measure. This method provides precise curative effect, and it contains value for clinical promotion in the treatment of hepatolith.