摘要
目的探讨腹腔镜下经纤维胆道镜结合iMES-I-B型微电极碎石仪治疗胆道结石的临床效果及安全性。方法回顾性分析我院2017年7月至2019年3月采用微电极碎石技术治疗取石困难的胆道结石患者50例的临床资料。观察微电极碎石效果以及胆道损伤等并发症,记录取石时间,统计结石取净率。结果21例患者微电极碎石后通过生理盐水冲洗自行排出,其余29例进一步应用网篮套取结石,从开始碎石到取净结石的时间为20~65min,平均(41.5±11.2)min,结石取净率为100%(50/50)。术中胆管壁出血3例,术后胆漏2例,术后住院时间为7~14d,平均(10.2±2.1)d,无患者中转开腹或胆道穿孔。术后4~6周造影无异常拔除T管。结论在腹腔镜下经纤维胆道镜结合iMES-I-B型体内微电极碎石仪治疗取石困难的胆道结石是一种安全、可靠、高效的方法。
Objective To investigate the clinical effect and safety of laparoscopy combined with fibrocholedochoscopy and iMES-I-B microelectrode lithotripsy in the treatment of bile duct stones.Methods The clinical data of 50 patients with difficult extrahepatic and intrahepatic bile duct stones underwent microelectrode lithotripsy treated in our hospital from July 2017 to March 2019 were retrospectively analyzed.The effect of microelectrode lithotripsy,biliary tract injury and other complications were observed.The time of stone removal and stone free rate were counted.Results The calculi were washed out by saline in 21 cases and collected by stone basket in 29 cases after microelectrode lithotripsy.The time of stone removal were 20~65 minutes,with the average time of(41.5±11.2)minutes,the stone free rate were 100%(50/50).Intraoperative hemorrhage were in 3 cases,postoperative bile leakage were in 2 cases.The hospitalization time was 7 to 14 days,with the average time of(10.2±2.1)days.None of the cases was converted to laparotomy.No bile duct perforation occurred.The T tube was removed 4~6 weeks after operation.Conclusion iMES-I-B microelectrode lithotripsy treated for difficult bile duct stones via fibrocholedochoscopy is a safe and reliable method,which obviously raises the stone free rate of bile duct stones.
作者
张伟
尚培中
吕瑞昌
吉玉洁
南润玲
李晓武
苗建军
张金江
蔡大伟
赵伟男
张洁
ZHANG Wei;SHANG Pei-zhong;LYU Rui-chang;JI Yu-jie;NAN Run-ling;LI Xiao-wu;MIAO Jian-jun;ZHANG Jin-jiang;CAI Da-wei;ZHAO Wei-nan;ZHANG Jie(Department of General Surgery,251th Hospital of PLA,Zhangjiakou Hebei 075000,China)
出处
《局解手术学杂志》
2019年第6期486-489,共4页
Journal of Regional Anatomy and Operative Surgery
基金
张家口市科学技术研究与发展计划项目(1821115D)
关键词
胆道结石
胆道外科手术
腹腔镜检查
胆道镜检查
微电极碎石
choledocholithiasis
biliary tract surgical procedures
laparoscopy
choledochoscopy
microelectrode lithotripsy
