【摘要】 目的探讨经皮肝胆道硬镜碎石术治疗肝内胆管结石的有效性和安全性。方法回顾性分析我院2014年1月至2015年7月68例应用经皮肝胆道硬镜碎石术治疗肝内胆管结石患者的临床资料。结果 68例患者均成功施行经皮肝胆道硬镜碎石术,其中56例一次性取净结石,结石取净率为82.4%(56/68),12例经2次、3次手术取净结石。手术时间50~210 min,平均100.0±12.5 min;取石次数为1~3次,平均1.2±0.9次;术中出血量2~180 mL,平均20.0±5.5 mL;住院3~21 d,平均8.0±3.1 d。术后并发右侧胸腔积液1例,并发症发生率为1.5%,术后未发生胆漏、严重出血等并发症。随访2年,3例结石复发,复发率为4.4%。结论经皮肝胆道硬镜碎石术对于肝内胆管结石的治疗是微创、安全和有效的,但并发症、解释残余率高是其实施的主要限制。更多还原

【Abstract】 Objective To report the experience in performing percutaneous transhepaticcholangioscopic lithotomy(PTCSL)for treating intrahepatic bile duct stone. Methods Retrospectiveanalysis of therapeutic result of 68 patients with intrahepatic bile duct stone during January 2014 to June2016. Results All of 68 cases were successfully performed with percutaneous transhepaticcholangioscopic lithotomy. In each patient,the number of sessions of PTCS varied from 1 to 3,and 56 cases(82.4%)got stone removal on one session 12 cases got stone removal in two-or three-stage. Theblood loss was ranged from 2 to 180 mL. The hospitalization was 3 to 21 days. Right pleural effusionoccurred in one cases after operation. Postoperative complication rate was 1.5%. No serious complicationssuch as bile leakage and bleeding occurred. After 2 years of follow-up,3 stones recurred(4.4%).Conclusion In our series,PTCSL was a safe and effective method with minimal invasion for managementof the intrahepatic bile duct stone,PTCS is a useful alternative management for the intrahepatic bile ductstone to surgery for biliary calculi,but it has limitations that obviate complete stone clearance.更多还原