纤维胆道镜联合术中B超在肝胆管结石手术中的应用

Application of fibercholedochoscopy combined with B-type ultrasound in the treatment of hepatolithiasis

目的探讨纤维胆道镜联合术中B超在肝胆管结石手术中的应用价值。方法选择108例肝胆管结石患者，术中随机采用单纯纤维胆道镜（A组，n＝54）和纤维胆道镜联合术中B超（B组，n＝54）治疗肝胆管结石。临床随访3年，记录术后患者并发症、残石率、结石复发率及临床疗效。结果术后B组残石率低于A组（1.85%比5.56%，P〈0.05），且结石复发率显著降低（7.4%比18.5%，P〈0.05）。随访期间，B组临床疗效显著优于A组（P〈0.05）。两组手术并发症发生率比较差异未见统计学意义（P〉0.05）。结论纤维胆道镜联合术中B超能显著减少肝胆管结石术后的残石率，降低远期复发率，提高临床疗效，是未来肝胆管结石手术的发展趋势。

ObjectiveTo investigate the application of fibercholedochoscopy combined with B-type ultrasound in the treatment of hepatolithiasis.MethodsThe 108 cases of hepatolithiasis were treated by fibercholedochoscopy （group A, n=54）or combined with B-type ultrasound（group B, n=54）, and followed up for 3 years. The stone recurrent rates, curative effects and residual stone rates were compared.ResultsCompared with group A, the stone recurrent rate and residual stone rate of group B were significantly lower（1.85% vs 5.56% and 7.4% vs 18.5%, P〈0.05）. The curative effect of group B was more remarkable（P〈0.05）. However, there was no significant difference in complication between the two groups（P〉0.05）.ConclusionsThe fibercholedochoscopy combined with B-type ultrasound can reduce the postoperative residual stone rate, the rate of recurrence and improve the clinical curative effect, is the future development trend of intrahepatic duct stone surgery.