经皮经肝穿刺多种介入技术联合治疗胆总管结石的疗效分析  

Percutaneous transhepatic various interventional technique for treatment of common bile duct stones

作　　者：荣育威 张希全 朱亮 钟山[1,2] 崔佳佳[1] 

机构地区：[1]潍坊医学院医学影像系,山东潍坊261053 [2]解放军第一四八中心医院介入血管科

出　　处：《实用放射学杂志》2014年第12期2047-2049,共3页Journal of Practical Radiology

摘　　要：目的：探讨经皮经肝穿刺肝内胆管应用多种介入技术治疗胆总管结石的临床疗效和应用价值。方法回顾性分析46例胆总管结石患者的临床资料。所有患者均先经皮经肝穿刺肝内胆管行胆管造影,明确结石数目、部位及大小。依据结石的大小置入碎石网篮碎石,再置入相应大小的球囊扩张十二指肠乳头,用球囊推石入肠。取石术后常规放置胆道内外引流管2周。结果手术成功45例,成功率97.83%,41例1次取石成功,4例2次取石成功。术中未发生严重并发症。术后早期并发症：3例高淀粉酶血症,1例急性胰腺炎,2例胆汁性腹膜炎,无出血及穿孔病例。结论经皮经肝穿刺多种介入技术联合取石成功率及安全性高,且可保留乳头括约肌功能,值得临床推广应用。Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

关 键 词：胆总管结石 经皮经肝球囊扩张 胆管造影 

分 类 号：R575.7[医药卫生—消化系统] R815[医药卫生—内科学]