经口胆道子母镜联合激光碎石治疗胆管巨大嵌顿性结石的效果及安全性  

Efficacy and safety of peroral duodenoscope-assisted cholangioscopy combined with laser lithotripsy in the treatment of giant incarcerated bile duct stones

作　　者：刘洪波 赵志鸿 温永春 刘军龙 陈曙光 Liu Hongbo;Zhao Zhihong;Wen Yongchun;Liu Junlong;Chen Shuguang(Department of Hepatobiliary Surgery,the First People’s Hospital of Luoyang,Luoyang 471000,China)

机构地区：[1]河南省洛阳市第一人民医院肝胆外科,471000

出　　处：《中国实用医刊》2021年第18期23-26,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨经口胆道子母镜联合激光碎石治疗胆管巨大嵌顿性结石的效果及安全性。方法抽取2016年3月至2020年3月洛阳市第一人民医院收治的胆管巨大嵌顿性结石患者27例,均予以经口胆道子母镜联合激光碎石治疗。统计其治疗效果及复发情况,分析围术期炎性应激、胆汁成石成分相关指标。结果 27例患者均手术成功,一次性结石取净率为88.89%(24/27)。术后12、24 h,血清肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)水平较术前升高(F=14.862、26.594、55.293,P<0.05)。术后3、6个月,总胆红素(TBIL)、总胆汁酸(TBA)、钙离子、胆固醇(CHO)较术前下降(F=122.338、226.871、79.680、45.342,P<0.05)。27例患者术后6个月无复发。结论经口胆道子母镜联合激光碎石治疗胆管巨大嵌顿性结石有效率高、无复发,是一种安全的治疗方法。Objective To investigate the efficacy and safety of peroral duodenoscope-assisted cholangioscopy combined with laser lithotripsy in the treatment of giant incarcerated bile duct stones.Methods A total of 27 patients with huge incarcerated bile duct stones who were admitted to the First People’s Hospital of Luoyang from March 2016 to March 2020 were selected.All patients were treated with peroral duodenoscope-assisted cholangioscopy combined with laser lithotripsy.The treatment effect and recurrence were counted,and the related indicators about perioperative inflammatory stress and bile stone components were analyzed.Results The operation was successful in all 27 patients,and the one-time stone removal rate was 88.89%(24/27).At 12 and 24 hours after operation,the serum tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),and interleukin-6(IL-6)levels were higher than those before operation(F=14.862,26.594,55.293,P<0.05).At 3 and 6 months after operation,total bilirubin(TBIL),total bile acid(TBA),calcium ion content,and cholesterol(CHO)were lower than those before operation(F=122.338,226.871,79.680,45.342,P<0.05).Twenty-seven patients had no recurrence 6 months after operation.Conclusions The combination of peroral duodenoscope-assisted cholangioscopy and laser lithotripsy is a safe treatment method for the treatment of huge incarcerated bile duct stones with high efficiency and no recurrence.

关 键 词：结石 经口胆道子母镜 激光碎石 胆管巨大嵌顿性结石 

分 类 号：R657.4[医药卫生—外科学]