【摘要】 目的探讨复杂型胆道残余结石的治疗方法和临床效果。方法分析46例胆道镜结合体内冲击波碎石治疗复杂型肝内外胆管结石的资料。经T管窦道使用胆道镜,插入等离子体冲击波电极对准结石击发(一般接通30次以内),将结石击碎后取净结石。结果该组46例碎石取石成功45例,总的碎石取石成功率为97.8%,有1例胆总管下端胆固醇结石没有完全击碎,采用其他方法取出。治疗期间并发胆道少量出血3例、发热1例,均经过保守治疗痊愈。结论等离子冲击波碎石内镜治疗胆道结石安全有效,创伤小,并发症少,是当前治疗胆道术后残余结石的有效方法 ,但胆固醇结石碎石较费时。更多还原

【Abstract】 [Objective]To investigate the method and the clinical results of treatment of complicated residual bile duct stones. [Methods]The clinical data of 46 patients with complicated intrahepatic or extrahepatic lithiasis treated by choledochoscopy combined with ISWL were retrospectively reviewed. The lithotripsy was carried out through choledochoscopy via T tube fistula, and the shockwave electrode was inserted to break stones by sending shock waves (usually no more than 30 times) and then all the breaked stones were cleared up with stone basket. [Results]In this study, ISWL was successfully performed in 97.8% (45/46) cases. Only one patient with cholesterol calculus in common bile duct broken totally by ISWL was exposure to other method to remove all the calculus. The major complications were a small amount of hemobilia (6.5%, 3/46) and fever (2.1%, 1/46), and all these complications were cured by non-surgical treatment.[Conclusion]Owing to its advantages such as safety, effectiveness, mini-trauma and few complications, the internal shock wave lithotripsy combined with choledochoscope microinvasive techniques is currently an effective approach for treatment of postoperative complicated residual bile duct stones, but more time in cholesterol calculus.更多还原