经皮胆道造瘘胆道镜取石、球囊扩张术治疗复发肝内胆管结石46例临床观察  

Clinical analysis of 46 case of recurrent intrahepatic cholelithiasis treated by choledochoscopy and balloon dilatation

作　　者：陈壮浩[1] 李建明[1] 宋巍巍[1] 李伟[1] 郭锋满 常建星[2] CHEN Zhuang-hao;LI Jian-ming;SONG Wei-wei;LI Wei;GUO Feng-man;CHANG Jian-xing(Third Branch of Surgery Zhongshan Hospital of traditional Chinese Medicine,Zhongshan,Guangdong 528400,China;Department of General Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen Univer-sity,Guangzhou 510120,China)

机构地区：[1]中山市中医院外三科,广东中山528400 [2]中山大学孙逸仙纪念医院普通外科,广州510120

出　　处：《岭南现代临床外科》2020年第6期699-702,710,共5页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨经皮胆道造瘘胆道镜取石、球囊扩张术治疗复发肝内胆管结石46例的临床价值。方法回顾2015年1月~2018年12月我院经皮胆道造瘘取石,球囊扩张术治疗复发肝内胆管结石患者46例的临床资料。结果在46例复发肝内胆管结石患者中,完全取尽结石者43例(93.5%),术后胆道出血6例(13%),胆漏1例(2.2%),胆管炎4例(8.7%),发热8例,呕吐5例。无死亡病例,随访2年,6例(12.2%)结石复发。结论经皮胆道造瘘胆道镜取石、球囊扩张术治疗复发肝内胆管结石取得良好的效果,取石安全有效,且微创,可作为胆道结石治疗手段的有效补充。Objective To explore the clinical value of percutaneous choledochostomy,choledochoscopy and balloon dilatation in the treatment of 46 cases of recurrent intrahepatic cholelithiasis.Methods From January 2015 to December 2019,the clinical data of 46 patients with intrahepatic cholelithiasis treated by percutaneous choledochostomy and balloon dilatation were reviewed.Results Among 46 patients with recurrent intrahepatic cholelithiasis,43(93.5%)had stones completely removed,6(13%)had postoperative biliary bleeding,1(2.2%)had biliary fistula,4(8.7%)had cholangitis,8 had fever,and 5 had vomiting.There was no death.Follow⁃up for two years showed that 9 cases(12.2%)had stone recurrence.Conclusion Percutaneous choledochostomy,chodedochoscopy and balloon dilatation for the treatment of recurrent intrahepatic bile duct stones have achieve good results,stone extraction is safe and effective,and minimally invasive,which can be used as an effective supplement to the treatment of bile duct stones.

关 键 词：肝内胆管结石 经皮胆道造瘘碎石取石术 球囊扩张 临床分析 

分 类 号：R657.42[医药卫生—外科学]