胆总管下端结石的诊断与治疗  

Diagnosis and treatment of retained and recurrent bile duct stones

作　　者：宋文虎[1] 李宜雄[1] 

机构地区：[1]中南大学湘雅医院普外科,湖南长沙410008

出　　处：《中国医学工程》2006年第2期176-177,共2页China Medical Engineering

摘　　要：目的探讨胆总管下端结石的发病机制、临床特点及治疗方法。方法对2004年1月￣2005年1月该院收治的65例胆总管下端结石病人的临床资料进行总结分析。结果65例胆总管下端结石病人中33例通过开腹行胆总管切开取石、T管引流术,术中、术后纤维胆道镜取石治愈;7例(包括4例EST取石失败的病人及2例外院行胆总管空肠Roux-en-Y吻合后的病人)行术中纤维胆道镜取石、胆总管空肠Roux-en-Y吻合,全部治愈;29例行EST术,25例治愈。结论胆总管下端结石是胆石症病人术后的常见并发症。彻底取净结石是防治该症的关键。该症以手术治疗为主。[Objective] To investigate the diagnosis and treatment of retained and recurrent bile duct stones. [Methods] The clinical data of 65 patients with retained and recurrent bile duct stones from 2004 to 2005 were retrospectively analyzed. [Results] Forty of them underwent cholecystectomy; 29 cases received EST （4 cases failed）. In the forty cases group： Thirty-three cases underwent choledochostomy with T tube drainage; Seven cases recived choledochojejunostomy （including 4 failed EST case and 2 failed operation cases）. [Conclusion] Recurrent bile duct stones are a common complication secondary to cholecystectomy and choledocholithotomy. Complete choledocholithotomy play a key role in prevention of retained and recurrent bile duct stones. Operation is the major means for its management.

关 键 词：胆石症 并发症 再手术 

分 类 号：R657.42[医药卫生—外科学]