研发胆道取石硬镜经T管瘘道治疗胆道术后残留结石  

The management of biliary tract postoperative residual stones with hard choledochoscope through T-tube fistulous tract

作　　者：顾思平 蔡晓东[2] 游志远[2] 熊共鹏[3] 周晓明[2] 

机构地区：[1]泉州万祥微创医院微创外科,泉州362000 [2]福建省石狮市医院微创外科 [3]厦门市中医院

出　　处：《中华腔镜外科杂志（电子版）》2012年第4期47-49,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：泉州市科技局立项资助项目(编号:2009z18)

摘　　要：目的探讨胆道结石术后用研发胆道取石硬镜（或输尿管镜）经T管瘘道探查和治疗残余结石的疗效。方法回顾性分析在利多卡因凝胶5~10ml注入瘘道局部麻醉后采用研发的胆道取石镜（或输尿管镜）经T管瘘道探查和治疗42例胆道结石术后病例的资料。结果全组42例患者中前期（2010年3月以前）20例中有10例顺利完成探查或取石术,另10例在探查胆总管下段时,腹痛明显而中止改用纤维胆道镜探查,后期（2010年3月以后）的22例有19例完成胆道探查或取石,有3例在探查胆总管下段时腹痛难忍中转纤维胆道镜探查。1例腹腔镜胆总管切开术后52d拔T管,经瘘道胆道取石镜探查发现瘘道未形成,出现胆汁性腹膜炎,后开腹手术治愈,其余病例无并发症出现。结论胆道结石术后经T管瘘道常规使用研发胆道取石硬镜（或输尿管镜）探查和治疗胆道残余结石,安全有效,操作简便,为临床提供一种治疗胆道术后残留结石的新方法,有临床推广价值。Objective To investigate the efficacy of the management of biliary tract postoperative residual stones with hard choledochoscope（or ureteroscopy） through T-tube fistulous tract. Methods A retrospective analysis 42 patients who had biliary tract postoperative residual stones received the management of exploratory and lithotripsy with hard choledochoscope which was inventived by us（or ureteroscopy） through T-tube fistulous tract. Results In the early to carry out this operation （before March 2010） ,10 of 20 were completed the exploration or lithotomy successfully, the other 10 cases were with fierce abdominal pains when explorating the lower segment of common bile duct, then switch to the exploration with choledochofiberscope;In the late to carry out this operation （after March 2010）,19 of 22 were completed the exploration or lithotomy successfully, 2 cases were with fierce abdominal pains when explorating the lower segment of common bile duct, then switch to the exploration with choledochofiberscope, One case of laparoscopic common bile duct postoperative 52 days to remove the T tube , through the fistula with hard choledochoscope we found that the fistula tract was not fully formed,and patient had bile peritonitis then received abdominal surgery to cure. The remaining cases had no complications. Conclusions The management of biliary tract postoperative residual stones with hard choledochoscope inventived by us（or ureteroscopy） through T-tube fistulous tract ,is safe and effective, easy to operate, provides a new clinical method to treat the bile duct residual stones ,has the value of the promotion.

关 键 词：研发胆道取石硬镜 胆道术后 残余结石 

分 类 号：R657.4[医药卫生—外科学]