术中胆道造影联合胆道镜治疗胆石症的临床体会  

Clinical experience of the cholangiography combined with cholangioscopy treatment cholelithiasis

作　　者：肖光云[1] 

机构地区：[1]都江堰市人民医院普外科,四川都江堰611830

出　　处：《中外医疗》2012年第14期27-28,共2页China & Foreign Medical Treatment

摘　　要：目的评估术中经T型管胆道造影联合胆道镜检查在治疗肝胆结石中的意义。方法回顾性分析我院肝胆外科2009年8月～2011年8月间78例肝胆结石患者术中经T型管胆道造影联合胆道镜治疗的临床资料。结果 78例肝胆结石患者中63例术前明确诊断存在肝胆结石,15例术前无明确结石发现;术中胆道镜新发现结石11例,假阴性结果 1例,胆道狭窄5例,胆道肿瘤2例,胆管感染1例;术中胆道造影新发现结石19例,假阳性结果 6例,假阴性结果 1例,胆道解剖异常3例、胆道狭窄2例,胆管感染1例;术后胆道探查发现新结石3例。结论术中胆道造影联合胆道镜治疗肝胆结石可进一步降低结石残留率,减少单独采用胆道造影或胆道镜出现的假阴性或假阳性结果,减少术后再次开腹取石的可能,安全有效,值得临床广泛应用和推广。Objective To determine the value of the cholangiography combined with cholangioscopy treatment cholelithiasis. Methods A retrospective analysis of our hospital hepatobiliary surgery from august 2009 to august 2011 was done on 78 patients with eholelithiasis by eholangiography combined with cholangioseopy treatment of clinical data intraoperative. Results There did 63 cases of 78 patients with cholelithiasis exist courage stone, the other 15 cases did not exist courage stone. Intraoperative, cholangiosc0py new found 11 cases with stones, l case of false negative results, 5 cases of biliary stricture, 2 eases of biliary tumor, 1 cases of bile duet infection and cholangiography new found 19 cases with stones, 6 case of false positive resuhs,1 case of false negative results, 3 cases of abnormal biliary anatomy,2 cases of biliary stricture, 1 cases of bile duct infection. Postoperative,biliary exporation new found 3 cases with stones. Conclusion Cholangiography combined with cholangioscopy treatment cholelithiasis can reduce the recurrence of residual duct stones, reduce the sole use of eholangiography or cholangioscopy the false negative or the positive resul, reduce the possible of takeing again postoperative adjacent stone.It is safe abd effective and worth clinical widely application promotion.

关 键 词：胆道造影 胆道镜 胆石症 联合 

分 类 号：R657.42[医药卫生—外科学]