经皮胆肠吻合口胆道镜治疗肝内胆管复发结石

目的探讨经皮胆肠吻合口胆道镜治疗胆管空肠Roux-en-Y吻合术后肝内胆管复发结石的方法及疗效。方法20．0．0年1月～2005年2月，对8例胆肠吻合术后肝内胆管再发结石，采用经皮经空肠输胆襻造口术建立通道，胆道镜经胆肠吻合口进入肝内胆管取石，纠正吻合口和肝内胆管狭窄。结果8例肝内胆管结石均取净，4例胆管狭窄和2例吻合口狭窄解除。8例随访1～3年，肝内胆管无复发结石和再狭窄。结论经皮胆肠吻合口胆道镜治疗肝内胆管复发结石创伤小、安全、可行，效果满意。

Percutaneous choledochoscopy through cholangio-jejunal anastomotic stoma for recurrent intrahepatic biliary duct stones

Objective To investigate methods and effects of percutaneous choledochoscopy via cholangio-jejunal anastomotic stoma in the treatment of recurrent intrahepatie biliary duct stones. Methods Eight cases of recurrent intrahepatic biliary duct stones after a Roux-en-Y cholangiojejunostomy from January 2000 to February 2005 were treated with percutaneous choledochoscopy. An enterostomy was made at the afferent jejunal loop. Then a choledochoscope was introduced into the intrahepatic biliary ducts by way of the cholangio-jejunal anastomotic stoma for stone removal and intrahepatic duct or anastomotic stoma dilatation. Results The intrahepatie stones were thoroughly removed in all the 8 cases. The biliary duct stenosis in 4 cases and the anastomotie stoma stenosis in 2 cases were relieved. Follow-up checkups in the 8 cases for 1 -3 years revealed no recurrence of intrahepatie stones or stenosis. Conclusions Percutaneous eholedoehoseopy via cholangio-jejunal anastomotie stoma is minimally-invasive, safe, feasible, and effective in the treatment of recurrent intrahepatie biliary duct stones.