内镜下胆总管取石后胆囊切除治疗胆总管继发结石

目的 观察内镜下胆总管取石后单纯行胆囊切除，避免胆总管探查，Ｔ管引流对胆囊结石、胆总管继发结石患者治疗的安全性和有效性。方法 ３７例胆囊结石、胆总管继发结石的患者在常规行ＥＲＣＰ检查的同时行内镜下胆总管取石（必要时行ＥＰＴ、液电碎石术），财生胆囊切除。结果 （１）胆总管结石直径在１．５ｃｍ以内者２７例，内镜下１００％成功取净结石。１０例胆总管结石直径在１．５￣３．０ｃｍ之间者经液电碎石后取净结石８

CHOLECYSTECTOMY AFTER ENDOSCOPIC STONE REMOVAL FOR COMMON BILE DUCT STONES

Objective To observe the safety and effectiveness of cholecystectomy after endoscopic stone removal for common bile duct stones.Methods Endoscopic stones removal (endoscopic sphincterotomy and lithertripsy were done if necessary) have been performed in 37 patients with gallstones and common bile duct stones when they were examined by ERCP,then cholecystectomy was performed.Results (1)The common bile duct stones diameter were shorter than 1.5cm in 27 cases,of which the success rate of stone removal was 100%.Stones size ranged from 1.5-3.0cm in diameter in 10 cases,of which 8 patients were successfully performed endoscopic stone removal after lithertripsy.The total success rate of endoscopic stone removal was 94.55% in this group.(2)33 patients in this group were successfully treated by cholecystectomy after endoscopic stone removal,the success rate was 89.19%,the truma was small and the complications were decreased meganificently.Conclusions Endoscopic stone removal is simple,safe and high in success rate,cholecystectomy after endoscopic stone removal is the safe and effective method and represents a promising alternative to surgery in cases with gallstone and common bile duct stone.The patients can avoide choledochostomy,complicatons and the danger of the operation,and the time in hospital are decreased.