纤维胆道镜治疗胆道术后残留结石的体会

本文报道25例胆道术后残留结石患者,用纤维胆道镜经T管窦道取石的初步经验。25例胆道残留结石有3例合并胆道蛔虫,1例合并胆总管下端狭窄。全组25例,取除结石及蛔虫成功22例,成功率为88％,取净结石20例,取净率为91％,1例胆总管下端狭窄,试用纤维胆道镜内插入PTCD导丝,导管扩张狭窄部分,取得良好效果。本文对纤维胆道镜术后直型引流管插入和固定的方法进行了改进,提高了安全性和可靠性,减少了早期导管滑脱的并发症。并对3例取石失败的原因进行了分析。

REMOVEMENT OF POSTOPERATIVE REMAINED BILE DUCT STONES WITH CHOLEDOCHOFIBERSCOPE

The procedure for removing postoperative remained bile duct stones with cho- ledochofiberscope through T-tube tract was performed in 25 patients and was su- ccessful in 22 cases, with a success rate of 88%, In 20 of the 22 cases the rema- ined stones wore cleared away completely and the clearance rate was 91% Among the 25 Patients there were three cases complicated with bile duct ascariasis and one case with inferior and stenosis of the common bile duct. In the latter a PTCD lead-line Was inserted Into the choledochofiberscope to dilate the contricttive part and a satisfactory result was received. To increase the safety and reliability of the procedure and to prevent complications and early lip of the inserted, cathe- ter, the methods of inserting straight catheter into the common duct was modified. In three of the 25 patients the remained stones failed to be removed. The causes of the failure were analysed.