【摘要】 目的探讨输尿管硬镜治疗胆道术后复杂性残留结石的方法及临床价值。方法收集83例胆总管切开取石T管引流术后患者,经B超、CT或T管造影检查证实为肝内外胆管残留多发、鹿角/铸型或胆总管下端嵌顿结石,采用输尿管硬镜配合气压弹道/钬激光碎石、取石,对其效果进行回顾性分析。结果 83例患者碎石、取石均获成功。其中一次取净结石45例,二次取净结石26例,三次取净结石12例。手术时间75~165(112.5±46.5)min。术中无明显出血、胆管损伤,术后无胆漏、菌血症、肝功能损害及胰腺炎发生。结论经T管窦道输尿管硬镜配合气压弹道/钬激光行胆道术后复杂残留结石碎石、取石,进一步丰富了胆道结石的治疗手段,且该方法方便、快捷、可操作性强,具有取石高效、安全、彻底等优势,值得临床推广。更多还原

【Abstract】 Objective To investigate the methods and the clinical application value of urethroscopy in the treatment of postoperative complex residual calculi in biliary tract. Method 83 patients who were diagnosed as multiple residues extrahepatic bile duct,antlers/mold and common bile duct stones by B ultrasound,CT or T-tube cholangiography. These patients suffering from postoperative complex residual calculi in biliary tract were treated with urethroscopy combined pneumatic lithotripsy or holmium laser.The clinical data of 83 cases were analyzed retrospectively. Results The calculus were completely removed firstly in 45 of the 83 cases,removed in 26 cases through 2 times,and 12 cases through 3 times.The operation time was 75-165 min,with the mean time was( 112. 5 ± 46. 5) min. There were no obvious bleeding,bile duct injuries during the operation and no postoperative bile leakage,bacteremia,liver damage and pancreatitis. Conclusion Urethroscopy in the treatment of postoperative complex residual calculi in biliary tract is a percutaneous nephrolithotomy technology used in the treatment of biliary calculi. It further enriches the treatment of biliary calculi. And the method is convenient,fast,easy to operate,efficient,safe,and has a good clinical significance and application value.更多还原