腹腔镜下胆道镜联合微爆破碎石仪治疗胆道结石的临床探讨  

Clinical Exploration of Shockwave Lithotripsy under Laparoscope Combined with Choledochoscope for the Treatment of Hepatobiliary Calculi

作　　者：王彦铭[1] 向证文[1] 王雨龙 李钢[1] 黄健[1] 王宁[1] 唐和平[1] 

机构地区：[1]绵阳市人民医院肝胆外科,四川绵阳621000

出　　处：《华西医学》2013年第4期528-531,共4页West China Medical Journal

摘　　要：目的探讨腹腔镜下胆道镜联合微爆破碎石术仪治疗肝胆管结石的安全性及治疗效果。方法回顾分析2008年7月-2012年6月183例胆道结石患者,行腹腔镜下胆道镜联合微爆破碎石仪治疗或单纯经内镜Oddi括约肌切开取石治疗的临床资料。87例患者在术中均应用微爆破碎石仪碎石(微爆破组),96例患者行单纯经内镜Oddi括约肌切开术或经内镜乳头切开术碎石(对照组)。结果微爆破组碎石成功率100%,结石取净率85.06%(74/87),微爆破组的碎石时间、平均住院时间、平均住院总费用、并发症发生率均明显低于对照组(P<0.05)。结论腹腔镜下胆道镜联合微爆破碎石术在治疗肝胆管结石病方面,具有微创、安全、经济有效的优点,能降低结石残留率及取石次数,值得临床推广。Objective To evaluate the efficacy and safety of shockwave lithotripsy under both laparoscope and choledochoscope in the treatment of refractory intrahepatobiliary and extrahepatobiliary calculi. Methods The clinical data of 183 consecutive patients with intrahepatobiliary and extrahepatobiliary calculi treated from July 2008 to June 2012 were retrospectively analyzed. Shockwave lithotripsy under both laparoscope and choledochoscope or EST was performed for these patients. Eighty-seven patients in the shockwave group underwent laparoscope-combined choledochoscope shockwave lithotripsy, while 96 patients in the control group received EST. Results Choledochoscope shockwave lithotripsy was successfully performed in 87 patients （100%）, and the rate of calculi clearance was 85.06% （74/87）. The lithotripsy time, average hospitalization time, average cost of hospitalization, and complications were significantly lower than those of the control group （P 〈 0.05）. Conclusion Shockwave lithotripsy under laparoscope combined with choledochoscope is proved to be safe and worth promoting.

关 键 词：肝胆管结石 腹腔镜 胆道镜 微爆破碎石 

分 类 号：R657.4[医药卫生—外科学]