纤维胆道镜在治疗胆道术后肝胆管残余结石中的应用体会

The Application of Fiber Choledochoscope in the Treatment of Hepatic Duct Residual Calculi after Biliary Tract Surgery

目的:探讨纤维胆道镜在胆道术后肝胆管残余结石治疗中的临床应用价值和治疗体会。方法:回顾性分析笔者所在医院自2007年4月-2015年12月肝胆结石经手术治疗患者的临床资料,分析术后应用纤维胆道镜经窦道取石的取净率及并发症。结果:683例患者中,术后胆管残余结石431例,残石率约63%。采用术后纤维胆道镜治疗肝内外胆管结石后,397例患者全部取净结石,取净率92%。对患者在术前采用肌肉注射"盐酸哌替啶"镇痛处理,可以缓解呕吐症状。合并胆道出血,使用去甲肾上腺素的生理盐水冲洗控制。结论:纤维胆道镜通过T型管形成的窦道可基本清除肝胆管残余结石。

Objective： To explore the clinical application value and treatment experience of fiber choledochoscope in the treatment of hepatic duct residual calculi after biliary tract surgery.Method： Since April 2007 to December 2007, the clinical data of patients after hiliary tract surgery were collected.Fiber ehoiedochoscope was used through sinus tract to take out of calculi.Retrospective analysis was used to calculate the rate of clearance rate net and complications. Result： During 683 patients, 431 cases had residual calculi in hepatic duct after surgery.The rate of residual calculi was about 63%.Fiber choledochoscope was used in the treatment of residual calculi in hepatic duct, 397 patients＇ residual calculi were toke out, and the rate was 92%.Muscle injection of pethidine hydrochloride could relieve the symptoms of vomiting. Flushing of saline with norepinephrine was use to controi bleeding of biliary tract.Conclusion： Fiber eholedochoscope could basically remove the residual calculi in hepatic duct though via T tube fistula.