纤维胆道镜在胆道疾病中应用体会

Treatment of bile duct diseases: experience with choledochofiberscopy

目的 总结纤维胆道镜在临床胆道疾病中应用体会。方法 对我院1989-2001年间应用纤维胆道镜检查治疗的203例进行回顾性总结。结果 术中行纤维胆道镜检查治疗65例,肝内结石取净率为80％,确诊胆囊出血1例、胆总管远端癌2例、肝门部胆管癌1例和胆总管远端炎症狭窄3例。术后行纤维胆道镜检查治疗138例,结石取净率为97％,确诊肝内结石并胆管癌1例、胆总管远端乳头状瘤用微波治疗1例、Oddi括约肌开口狭窄经纤胆镜扩张治愈2例、肝门部胆管癌用微波凝灼治疗后置镍钛合金支架1例,同时对结石并肝内胆管狭窄者经纤维胆道镜应用微波治疗30例。结论纤维胆道镜在胆道疾病的诊断和治疗中起重要作用。

Objective To review the experience of choledochofiberscopy in bile duct disease. Methods The clinical data of 203 cases of bile duct disease with of choledochofiberscopy from 1989 - 2001 were analyzed. Results Intraoperative choledochofiberscopy was performed 65 cases, intrahepatic stones are take clean rate was 80% . Cholecystrrhagia was diagnosed in 1 case, choledoche end cancer 2 cases, choledoche end stenosis of inflammation 1 case. Postoperative choledochofiberscopy was used in 138 cases, intrahepatic stones are take clean rate is 97%, bile duct cancer was diagnosed in 1 case. Microwave was used in the treatment of diagnosechole-doche end papillate tumour in 1 case. Dilation was performed in 2 patients with stenosis of Oddi' s constrictor. Hilar cholangiocarcinoma was diagnosed in 1 patient and nickel tilanium alloy bracket was placed after treatment with microwave, to diagnose stenosis of intrahepatic and using wave cured 30 cases. Conclusions Choledochofiberscopy exerts importance action in the diagnosis and treatment of bile duct disease.