胆囊切除术后胆管残余结石29例分析

目的探讨胆囊切除术后胆管残余结石的原因及预防方法。方法回顾性分析29例胆囊切除术后胆管残余结石的临床资料。结果 29例胆囊切除术后胆道残余结石发生时间约术后6个月～15年,均经胆总管切开取石、T管引流术后治愈。结论术前全面检查、术中规范操作及合理选择术式,对可疑胆总管结石患者更应重视,可以采取术前CT、MRCP,术中胆管造影,既可降低胆管残余结石的发生率,又可避免不必要的阴性胆总管探查。

Analysis about 29 cases of residual biliary tract stones after cholecystectomy

Objective To investigate the causes and preventions of residual biliary tract stones after cholecystectomy. Methods Clinical materials of 29 cases with residual biliary tract stones after operation were analyzed retrospectively. Results Residual biliary tract stones formed generally from 6 months to 15 years after cholecystectomy.The primary closure of the bile duct and the T-tube drainage were conducted in 29 cases. Conclusion Overall preoperative examinations,standard step in operation and proper choice of operation are essential to prevent the occurrence of residual biliary tract stones.More attention should be paid to suspected choledocholithiasis patients.Preoperative CT,MRCP and intra-operative cholangiography are preferred,which can reduce the incidence of residual biliary tract stones and avoid unnecessary exploration in the common duct.