纤维胆道镜下球囊扩张术治疗肝内胆管狭窄的近远期疗效  

Short-term and long-term efficacy of choledochofiberscope balloon dilatation technique on intrahepatic bile duct stenosis

作　　者：张修稳 孙继林 胡飞 王士堂 Zhang Xiuwen;Sun Jilin;Hu Fei;Wang Shitang(Department of General Surgery,Feidong People＇s Hospital,Feidong 231600,China;Department of Biliary and Pancreatic Surgery,the First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei 230071,China)

机构地区：[1]安徽省肥东县人民医院普外科,231600 [2]中国科技大学附属第一医院安徽省立医院胆胰外科,合肥230071

出　　处：《中国实用医刊》2018年第21期61-63,共3页Chinese Journal of Practical Medicine

基　　金：合肥市医学重点学科建设计划资助（合卫科教2016-256）

摘　　要：目的 比较在纤维胆道镜下使用球囊扩张技术治疗肝内胆管狭窄的近期与远期疗效.方法 回顾性分析2012年3月至2015年9月安徽省立医院胆胰外科及肥东县人民医院普外科使用球囊扩张技术治疗的43例肝内胆管狭窄合并结石患者的临床资料.结果 43例患者共69处胆管狭窄合并胆管结石,给予球囊扩张后取石,其中扩张1次22例,2次13例,3次及以上8例;平均手术时间48.6 min,其中平均球囊扩张时间7.6 min;最后一次行扩张术后2周给予胆道镜检查,无胆管狭窄及结石复发.随访6～36个月,肝内胆管结石复发16例,复发例数随时间推移逐渐增加.结论 纤维胆道镜下使用球囊扩张技术治疗肝内胆管狭窄是一种高效、安全的方法,近期疗效良好,远期疗效略差.Objective To compare the short-term and long-term outcomes of choledochofiberscope balloon dilatation technique for intrahepatic bile duct stenosis .Methods The clinical data of 43 patients with intrahepatic bile duct stenosis complicated by stone calcification who underwent balloon dilation technique in Feidong People ＇s Hospital or Anhui Provincial Hospital , from March 2012 to September 2015, were retrospectively analyzed .Results Sixty-nine bile duct strictures complicated by bile duct stones were found in 43 patients.And they were treated by balloon dilatation to remove stones; of them, balloon dilatation were implemented once in 22 cases , 2 times in 13 cases , ≥3 times in 8 cases .The mean operation time was 48.6 minutes, and the mean balloon expansion time was 7.6 minutes.Choledochoscopy was performed 2 weeks after the last balloon dilation , and there was no recurrence of bile duct stenosis and stones.After 6-36 months of follow-up, 16 cases had recurrence of intrahepatic bile duct stones , and the number of recurrences increased with time .Conclusions Fibroblastoscopic balloon dilatation technique is a highly effective and safe treatment method for intrahepatic bile duct stricture .The short-term curative effect is good but the long-term effect is slightly poor .

关 键 词：胆管狭窄 球囊扩张术 胆道镜 

分 类 号：R657.4[医药卫生—外科学]