肝内胆管结石的内镜治疗  

A RETROPSECTIVE STUDY ON THE CHOLEDOCHOFIBERSCOPIC TREATMENT FOR PATIENTS WITH INTRAHEPATIC DUCT STONES IN 19 YEARS

作　　者：田伏洲[1] 张炳印[1] 赵铁军[1] 胡兵[1] 黄大熔[1] 胡建中[1] 

机构地区：[1]成都军区总医院全军普外中心,成都610083

出　　处：《肝胆外科杂志》2000年第4期251-253,共3页Journal of Hepatobiliary Surgery

摘　　要：目的　总结 19年来纤胆镜治疗胆管结石的经验。方法　回顾性分析近 19年来纤胆镜治疗肝胆管结石的病例。在 2 5 17例接受治疗的患者中 ,A组 ,术中纤胆镜取石者 116 2例 ,B组 ,术后经胆道引流管窦道治疗者 12 2 8例 ,C组 ,术后切开永久性皮下通道治疗者 12 7例。结果　A组配合肝段切除结石取尽率 94.4% ,B组结石取尽率 85 .6 % ,C组结石取尽率 92 .1%。结论　纤胆镜在肝内胆管结石的治疗中具有重要作用。但应强调外科手术相结合 ,争取在术中结合病灶切除等方法提高结石取尽率。手术建立永久性皮下通道 ,对复发结石的治疗和减少再次手术有重要作用。Objective To sum up the experiences in the choledochofibescopic treatment for patients with hepatolith during past 19 years.Methods 2517 cases with hepatolith who underwent choledochofiberscopic treatment were analysed retrospectively.Group A,1162 patients were treated with intraoperative endoscopic theraoy.Group B,1228 patients were treated with the endoscope after operation through the fistulas formed by the “T” tubers.Group C,127 cases, subcutaneous tunnel was opened first in order to put the endoscope into the bile duct.Results The cleaning rates in these three groups were 94.4%,85.6% and 92.1%,respectively.Conclusions The choledochofiberscope has played an important role in the treatment of the hepatolith.An appropriate operation is necessary for resecting the segments filled with stones in order to increase the cleaning rate of the hepatolith.A permanent subcutaneous tunnel connected to bile duct should be established in operation,so the recurrent hepatolith could be treated by endoscope.

关 键 词：内窥镜 纤胆镜 肝胆管结石 治疗 

分 类 号：R657.420.5[医药卫生—外科学]