经电子胆道镜螺旋水刀碎石治疗胆道结石

Intrahepatic calculosis lithotrity by helix hydro-jet under video choledochoscopy

目的 探讨经电子胆道镜应用螺旋水刀击碎肝内胆管结石的方法。方法 经电子胆道镜治疗孔插入直径 1 .6mm ,长 3m的内镜手柄 ,螺旋水刀喷嘴对准结石 ,采用压力 30～ 70bar和脉冲 1～ 2次 /s进行碎石 ,击碎后的结石用取石网取出或用水冲出。结果 本组 1 7例 ,碎石 30次 ,每次 1～1 .5h ,其中在手术中应用 6例 ,术后应用 9例 ,在手术中和术后均应用 2例 ,1 7例中共有 5 2枚直径 1～ 1 .5cm的肝内胆管结石被击碎并取净 ,无并发症发生。结论 应用螺旋水刀碎石效果可靠安全 ,不会损伤和击穿胆管 ,碎石过程不产生热量 ,易操作、压力易调整 ,无痛苦。本研究拓展了螺旋水刀的新用途 。

Objective To study the lithotrity of intrahepatic calculosis by using helix hydro jet under video choledochoscopy.Methods By using ERBE helix hydro jet with pressure of 30～70 bars and impulses of 1～ 2 Hz with the aid of video choledochoscopy, intrahepatic calculosis lithotrity was performed. The fragmentized calculosis were cleaned by grasping forceps and water.Results Results Of the 17 cases of intrahepatic calculosis, litrotrity was carried out for 30 times, 1～ 1.5 h every time. Six cases received lithotrity during operation, 9 cases after operation and 2 cases during and after operation. In 17 cases, there were 52 intrahepatic calculosis with 1 1.5 cm in diameter, which were fragmentized and cleaned out completely. No complications occurred during lithotrity.Conclusion Helix hydro jet lithotrity for intrahepatic calculosis was effective and safe without damage to bile duct.