改良的经皮经肝胆道镜术治疗肝内胆管结石(附15例报告)  

Improved percutaneous transhepatic cholangioscopy in the treatment of intrahepatic stone

作　　者：刘衍民[1] 曾可伟[1] 王纯忠[1] 陆光生[1] 文辉清[1] 

机构地区：[1]广州医学院第一附属医院微创外科中心,广州510230

出　　处：《外科理论与实践》2004年第6期485-486,共2页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨经皮经肝胆道镜术(PTCS)的新方法及其临床应用价值。方法:改良传统的PTCS方法,选择剑突旁入路。在经皮经肝胆管引流(PTCD)一周后,进行瘘道扩张并将隔离鞘套置入瘘道内,然后应用各种腔镜经鞘套进行胆道内碎石、取石、胆道扩张,置内支架治疗肝内胆管结石。就15例进行回顾性分析。结果:手术全部成功,完全取净率为86.7%(13/15),术后无胆瘘与出血并发症。结论:对部分肝内胆管结石,尤其是残留或复发结石及其伴随的胆道狭窄和阻塞性黄疸,改良的PTCS是一种创伤小、安全有效的术式。Objective To improve the method of percutaneous transhepatic cholangioscopy(PTCS) and evaluate it clinical value. Methods Fifteen cases of intrahepatic stones were treated using an improved technology which consisted in:①drainage of the bile duct; ②fistula dilatation and PTCS were performed one week after PTCD drainage; ③a sheath was put in after dilatation and lithotripsy was performed through the sheath. Results All cases of PTCS were successful and no complication of bile leakage and/or hemorrhage occurred. Stones were removed completely in 86.7%(13/15) Conclusions The Improved PTCS is a safe and effective method for treatment of intrahepatic stones,especially in recurrent cases.

关 键 词：肝内胆管结石 经皮经肝胆道镜 治疗 

分 类 号：R657.4[医药卫生—外科学]