术中胆镜及B超在肝内胆管结石诊治中的应用

Diagnosis and treatment of intrahepatic bile duct calculus by intraoperative choledochofiberscopy and B-ultrasonography

目的 探讨术中胆镜及B超在肝内胆管结石诊治中的价值。 方法 术中采用纤维胆道镜及B超检查对常规器械取石后的肝内胆管进行残余结石的判断 ,并在纤维胆道镜及B超指示下取出残石。 结果 4 7例肝内胆管结石应用术中常规器械取石后的残石率为 2 9 8% (1 4 / 4 7) ,经纤维胆道镜检查取石后的残石率下降到 1 0 6 % (5 / 4 7) (χ2 =5 2 6 7,P <0 0 5 ) ,经B超检查及取石后残石率为 4 7% (1 / 2 1 ) (P <0 0 5 )。

Objective To investigate the value of intraoperative choledochofiberscopy and B-ultrasonography for intrahepatic bile duct calculus. Methods After bile duct stone removal by routine instruments, choledochofiberscopy and B-ultrasonography were conducted for detecting and removing the residual cholelith in intrahepatic bile ducts. Results The incidence of residual cholelith was 29.8% (14 of 47) after stone removal by routine instruments, and it declined to 10.6% (5 of 47) ( χ 2=5.267, P <0.05) after a combined use of choledochofiberscopy and further dropped to 4.7% (1 of 21) ( P <0.05) after B-ultrasonography. Conclusions Intraoperative choledochoscopy and B-ultrasonography may effectively lower the incidence of residual cholelith in patients with intrahepatic bile duct calculus.