【摘要】 目的探讨胆道术后疑难残余结石取石的途径。方法胆道残余结石病人445例(1346例次)胆道镜诊治及系列分析。结果左肝内胆管尤其是左内叶胆管细长、角度大易形成结石,取石较难。壶腹部结石嵌顿取石1例诱发胰腺炎,3例曾Oddi括约肌切开,仍有壶腹部结石残留。“粗、短、直”的T管窦道取石方便,不易水肿。结论放置T管直径以22F、腹内段长度(11±1)cm为佳。胆道镜术中取石效果良好,用胆道镜取石治疗原发性肝内胆管结石伴门静脉高压症是一项安全有效的方法。更多还原

【Abstract】 Objective To investigate the approaches of removing the residual cholelithes postoperatively. Methods The clinical data of 445 patients with postoperative residual cholelithes in biliary tract treated in our hospital by choledocoscope from April 1995 to September 2004 were retrospectively analyzed. Results The removal of stone in the left hepatic bile duct, especially medial left duct, is more difficult because it was finer, longer and curveder than others. Sometimes the removal of the inlay stone at the heptopancreatic ampulla lead to pancreatitis. Three patients had residual stone even after EST. Wide, short and straight T tube is better than others. Conclusions The proper diameter of T tube is 22 F and the length in the cavity is 11±1 cm. Choledochoscope is a safe and beneficial method for treatment of primary cholelithiasis, hepatitis and hepatic cirrhosis with portal hypertension.更多还原