【摘要】 目的 探讨胆道镜检查在胆道疾患术式选择中的价值。方法 收集术中或联合术后应用胆道镜治疗的胆道疾患 182例临床资料，进行分析及总结。结果 134例胆管胆石症患者胆道残留结石率从 35.2％降至 9.7％； 30例术中胆道镜发现合并胆管狭窄，其中 15例肝胆管膜状狭窄者在胆道镜指导下实施了有效扩张治疗； 13例术后残留结石取尽 12例；胆总管下段梗阻病史中 24例肿瘤依据形态学检查，结合术中扪诊及活检组织学检查得到确诊，并采取了相应的手术方式。结论 胆道镜的应用有利于胆道疾患术式的选择，可使一些较为复杂的胆道手术变得简单易行；对术前未能确诊的病变可以达到明确诊断并指导选择合理的术式。更多还原

【Abstract】 Objective The significance of intra or postoperative choledochoscopy in selecting proper surgery for biliary disorders was evaluated. Methods The clinical materials of 182 patients undergoing choledochoscopy were reviewed. Results The rate of residual stones dropped from 35.2 to 9.7 percent in 134 cases with choledocholithiasis. With the scopy residual stones were extracted in 12/13 patients , biliary menbranous stenosis being dilated in 15/30 and the cause of malignant obstruction of lower common bile duct elucidated in 24 instances . Conclusion Intraoperative choledochoscopy is beneficial in the choice of appropriate operation for biliary disorders as well as in establishing correct diagnosis that is ambiguous before surgery.更多还原