输尿管硬镜在基层医院微创保胆取石术中的临床应用效果观察

Clinical effect of ureteroscopic surgery on minimally invasive gallbladder-preserving cholecystolithotomy in primary hospital

目的探讨输尿管硬镜在基层医院微创保胆取石术中的应用,为无胆道镜的基层医院开展微创保胆取石提供一种新器械。方法回顾性分析2013-01~2016-06该院开展的经胆囊底体表投影位置小切口入路,使用输尿管硬镜行保胆取石手术的50例患者的临床资料和治疗效果。结果保胆取石手术全部成功,手术时间为(62.3±15.5)min;术中出血量为(21.8±2.9)ml,术后无胆瘘等并发症发生。术后1周内复查B超或CT无结石残留。随访24个月,36例病例中,仅有1例复发。结论输尿管硬镜在微创保胆取石术中完全可以取净结石且安全可靠,值得基层医院推广。

Objective To investigate the clinical effect of ureteroscopic surgery on minimally invasive gallbladder-preserving cholecystolithotomy in primary hospital and to provide an alternative instrument for the primary hospitals without cholangioscopy.Methods The clinical data of 50 patients who were performed minimally invasive gallbladder-preserving cholecystolithotomy from January 2013 to June 2016 were retrospectively analyzed.Results All the operations were successful with average operation time of(62.3±15.5)min;and blood loss of(21.8±2.9)ml,and without postoperative biliary fistula complications.All the patients were rechecked by B ultrasound or CT and no residual stones were found 1 week after the operation.During the follow-up period of 24 months,1 case relapsed in 36 cases.Conclusion Ureteroscopy in proper use can take out all the gallstones in the patients in a primary hospital,with advantages of safety,minimal invasion and multi-purpose use of ureteroscopy.