经胆囊管胆道镜胆管探查取石43例

目的探讨胆囊切除术中经胆囊管纤维胆道镜检查、取石对胆总管结石的治疗价值。方法回顾分析2005年7月-2009年6月间,对43例有胆总管探查指征、高度怀疑有胆总管继发性结石的患者,在胆囊切除术中经胆囊管用胆道镜探查胆管并清除结石的临床资料。结果43例中,18例探查阴性,25例发现胆总管结石,直径2-6 mm。21例以取石网套取后,一次或分次自胆囊管取出;4例用取石网将结石推入十二指肠;行胆总管侧壁小切开33例,留置T形管5例,全组无并发症,术后平均8.4 d出院。结论经胆囊管胆道镜胆管探查、取石,符合微创外科的原则,胆囊结石合并胆总管结石者,无论是开腹还是腹腔镜手术,都可考虑选择经胆囊管途径行胆管探查取石术。

Choledochoscopy for calculi extraction and exploration through ductus cysticus:analysis of 43 cases

Aim To evaluate the therapeutic value of choledochofiberscope in calculi extraction and exploration for common bile duct(CBD) stone through cystic duct during the operation.Methods Analyzing clinical data of 43 patients having the sign of choledochotomy by exploration,who were treated with endoscope to remove the stones during the cholecystectomy from July,2005 to June,2009.Results The exploration was negative in 18 cases and stones were found at CBD in 25 cases.The average diameter of the stone was 2 to 6m...