摘要
目的探讨内镜下钬激光碎石治疗胆总管结石的方法与近期疗效,总结其技术要点。方法回顾性分析我院施行内镜下钬激光碎石治疗胆总管结石23例的治疗经过及近期随访结果,其中腹腔镜结合胆道镜手术8例,开腹胆总管切开取石12例,经T管窦道硬质输尿管镜下钬激光碎石治疗胆道残余结石3例。结果 23例均获成功,无胆道损伤、胆漏;其中1例腹腔镜结合胆道镜行胆总管探查术者因胆总管下段结石嵌顿、胆管粘膜水肿严重致视野不清仅行T管引流,二期经T管窦道钬激光碎石,余病例均获得一次性结石清除,2例术后胆道少量出血未行特殊处理自愈,随访3～6月无残留结石。结论钬激光碎石治疗胆管结石是一种安全、有效的方法。
Objective To evaluate the efficacy and safety of the holmium laser lithotripsy in the management of cholelithiasis.Methods 23 patients with hepatolithiasis or residual stones after bile duct operations were treated by holmium lithotripsy under fibro-choledochoscope,including 8 cases of laparoscopic choledochotomy,12 cases of open common bile duct exploration,and 3 cases of lithotripsy through T-tube.Results All the 23 cases achieved success without iatrogenic bile duct injury or biliary fistula.One patient who underwent the laparoscopic choledochotomy did not have the stone removed because of the incarceration of the stone and the edema of the common bile duct mucosa,so as to get the stone removed by the secondary holmium laser lithotripsy through T-tube.The stones of the other cases were all removed directly.2 patients suffered from the mild biliary tract hemorrhage,and were cured without hemostasis.All the cases had no stone residue during the 3 to 6 months follow-up.Conclusion Holmium laser lithotripsy under fibro-choledochoscope is an effective and safe method in the management of hepatolithiasis or residual stones after bile duct operations.
出处
《中国现代手术学杂志》
2011年第1期8-9,共2页
Chinese Journal of Modern Operative Surgery
