经皮经肝穿刺同期胆道镜取石治疗复发性肝胆管结石

目的总结应用经皮经肝穿刺同期胆道镜治疗复发性肝胆管结石的治疗经验。方法回顾性分析我院2014年10月~2016年6月22例复发性肝胆管结石患者,在同一次麻醉下,B超引导下经皮经肝胆道穿刺成功后,同期行胆道镜碎石取石的手术疗效。结果 21例患者穿刺后。取石成功,仅1例穿刺失败后中转开腹;1次取尽结石成功17例(81.0%),2次取尽结石者3例,3次取尽结石者1例,无严重并发症及死亡。随访至今无发现结石复发。结论对于复发性肝胆管结石患者,严格把握适应证,经皮经肝穿刺胆道镜同期治疗是可行、有效和安全的。

Synchronous treatment of percutaneous transhepatic and choledochoscopy for recurrent hepatoli- thiasis

Objective To Summarize our experience on percutaneous transhepatic one?stage lithotomy with choledochoscope in treatment of recurrent hepatolithiasis. Methods A retrospective analysis of clinical data in 22 cases with recurrent hepatolithiasis in our hospital from October 2014 to June 2016 was performed. The patients were treated by direct puncture of hepatic duct under B?ultrasound guidance to establish a percutaneous tract ，and then lithotomy with choledochoscope for extraction of the bile duct stones was performed contemporaneously. Results Twenty?one patients were successful to be extracted stone，only one patient was converted to laparotomy. Of 21 cases，17 were healed in one?time stone removal，three underwent two?time operation，one received three?time operation. The main complication was hemobilia and was treated conservatively ，and no serious complications and death. No recur?rence was found in all patients followed up until now. Conclusion In properly selected patients of recurrent hepatolithiasis，synchronous treatment of percutaneous transhepatic and choledochoscopy is feasible，effective and safe.