术中术后使用纤维胆道镜辅助治疗复杂肝胆管结石的临床分析（附66例报告）

目的探讨术中、术后应用纤维胆道镜辅助治疗复杂肝胆管结石的价值。方法自2003年9月～2009年12月我院手术配合纤维胆道镜探查胆道、取石332例,对其中66例复杂肝胆管结石的治疗方法和效果进行回顾性分析。结果本组66例复杂肝胆管结石病例,术后结石残留21例,结石残留率31.8%。术后经反复胆道镜取石,结石取出率达97%（64/66）。结论复杂肝胆管结石手术中,使用胆道镜取石结合术后用胆道镜经＂T＂管窦道取石可有效清除胆道中的残留结石。

Fiberoptic cholandochoscope in the use of adjuvant therapy of complicated hepatolithiasis during operation and after operation(A report of 66 cases)

Objective To investigate the value of intraoperative and postoperative application of fiberoptic choledochoscope in adjuvant treatment of complicated hepatolithiasis.Methods From September 2003 to December 2009,322 patients with hepatolithiasis were operated by the fiberoptic choledochoscope in exploring the biliary tract and removing the calculi.Among them,66 cases were diagnosed as complicated hepatolithiasis.The operative results of these patients were analyzed retrospectively.Results In 322 patients with hepatolithiasis,the total rate of postoperative biliary residual calculi were 7.2%（24/322）,while in respect to 66 cases with complicated hepatolithiasis,the rate of postoperative biliary residual calculus was 31.8%.However,with the repeated application of fiberoptic choledochoscope to remove calculi by were of T-tube sinus,biliary residual calculi could be removed in 97%（64/66 cases）.Conclusion In the surgical treatment of complicated hepatolithiasis,the application of fiberoptic choledochoscope is helpful in decreasing the rate of postoperative biliary residual calculi.Furthermore,repeated use of the fiberoptic choledochoscope by the way of the T-tube sinus can remove the residual stones efficiently.