一期经皮肝空刺硬质腥选镜与胆总管切开治疗肝内胆管合并胆总管结石的疗效比较  

Efficacy of phase I percutaneous transhepatic cholangioscopy versus common bile duct incision in intrahepatic bile duct and common bile duct stones: a comparative study

作　　者：谢嘉奋 李君[1] 岑钧华[1] 

机构地区：[1]广州医科大学附属第一医院肝胆外科,广东广州510120

出　　处：《广州医科大学学报》2015年第2期42-44,共3页Academic Journal of Guangzhou Medical University

摘　　要：目的:分析一期经皮肝空刺硬质腥选镜(PTCS)与传统胆总管切开治疗肝内胆管合并胆总管结石的临床疗效。方法:将2012年8月至2014年11月广州医科大学附属第一医院收治的74例肝内胆管合并胆总管结石患者分为对照组(传统胆总管切开,36例)和观察组(一期PTCS,38例),比较两组手术相关指标及术后并发症。结果:观察组和对照组手术时间、住院时间、术中出血量、结石残留例数分别为(210±36)min和(234±54)min、(5.2±1.8)d和(6.7±3.2)d、(24.2±6.8)m L和(28.9±8.6)m L、4例和11例,两组比较,差异均有统计学意义(P<0.05)。结论:与传统胆总管切开手术相比较,一期PTCS治疗肝内胆管合并胆总管结石临床效果更好,是一种安全、有效的微创治疗方法,值得推广应用。Objective： To investigate the clinical efficacy of phase I percutaneous transhepatic cholangioscopy（ PTCS） versus conventional common bile duct incision for the treatment of intrahepatic bile duct and common bile duct stone. Methods： Seventy-four patients with intrahepatic bile duct and common bile duct stone,who were hospitalized in First Affiliated Hospital of Guangzhou Medical University between August 2012 and November 2014,were divided into the control group（ conventional common bile duct incision,36 cases）and the observation group（ phase I PTCS,38 cases）. The related indicators of the operations and postoperative complications between the two groups were compared. Results： The operative time,hospital stay,blood loss during operation,cases of residual stones in the observation group and the control group were（ 210 ± 36） min vs.（ 234 ± 54） min,（ 5. 2 ± 1. 8） d vs.（ 6. 7 ± 3. 2） d,（ 24. 2 ± 6. 8） mL vs.（ 28. 9 ± 8. 6） ml,and 4 cases vs. 11 cases,respectively. There were statistically significant differences between the two groups（ P〈0. 05）.Conclusion： Phase I-PTCS has better clinical efficacy than conventional surgical operation in the treatment of intrahepatic bile duct and common bile duct stone,and therefore is a safe and effective minimally invasive treatment and justifies widespread use.

关 键 词：经皮肝穿刺 硬质胆道镜 肝内胆管合并胆总管结石 T管 

分 类 号：R657.4[医药卫生—外科学]