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胆道镜治疗肝内胆管残余结石疗效观察
引用本文:罗亚桐,黄飞舟,任树平.胆道镜治疗肝内胆管残余结石疗效观察[J].湖南师范大学学报(医学版),2004,1(1):23-25.
作者姓名:罗亚桐  黄飞舟  任树平
作者单位:1. 湖南师范大学医学院外科教研室,长沙,410006
2. 中南大学湘雅三医院外科,长沙,410011
摘    要:目的 :评估胆道镜治疗手术后肝内胆管残石的疗效和安全性。方法 :分析经T管窦道胆道镜取石 2 87例病人。结果 :2 87例肝内胆管残余结石中 2 11例取石成功 ,成功率 73.5 % ,在无胆管狭窄的 135例中 12 6例 (93.3% )取石成功 ,而伴有胆管狭窄的 15 2例中仅 85例 (5 5 .9% )取石成功。随访时间平均 4 2 .6月 (12~ 75月 ) ,在 2 11例取石成功病人中 191例 (90 .5 % )长期疗效优良 ,而 76例取石不成功者只有 12例 (15 .8% )疗效优良 ,两者具有显著差异 (P <0 .0 1)。结论 :经T管窦道胆道镜取石是术后肝内胆管残石处理的安全有效方法。胆管狭窄是导致取石失败的主要原因 ,成功取石可显著改善长期疗效 ,能使大部分病人免除再次手术

关 键 词:取石  胆道镜术  T管瘘道  胆管狭窄
文章编号:1673-016x(2004)01-0023-03
修稿时间:2004年9月22日

Choledochoscopic Removal of Retained Intrahepatic Stones Via a T-tube Tract
LUO Ya-tong,HUANG Fei-zhou,REN Shu-ping.Choledochoscopic Removal of Retained Intrahepatic Stones Via a T-tube Tract[J].Journal of Hunan Normal University(Medical Science),2004,1(1):23-25.
Authors:LUO Ya-tong  HUANG Fei-zhou  REN Shu-ping
Abstract:Objective To evaluate the efficacy and safety of choledochoscopic technique for postoperative residual intrahepatic stones. Methods Choledochoscopic technique was performed via a T-tube tract in 287 patients. Results Retained intrahepatic stones were extracted successfully in 211(73.5%) of the 287 patients. Of them, choledochoscopic technique was performed successfully in 55.9% patients with biliary stricture and in 93.3% patients without biliary stricture. Follow-ups ranged from12 to 75 months (average:42.6months). An excellent or good long-term result was obtained in 191(90.5%) patients whose retained stones were extracted successfully and in 12(15.8%) patients with unsuccessful procedure. Significant difference was noted in the both groups (P<0.01). Conclusion Choledochoscopic technique assisted removal of retained stones via the T-tube tract is a highly effective and safe procedure in the treatment of patients with residual intrahepatic stones after surgery. Biliary stricture is a major cause of unsuccessful procedure. Successful procedure may improve long-term results and allow the patients a last chance to avoid an unwanted reoperation.
Keywords:stone removal  choledochoscopy  T-tube tract  biliary stricture
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