胆道镜联合钬激光在胆道术后肝内胆管良性狭窄的应用

目的 探讨胆道镜联合钬激光在胆道术后肝内胆管良性狭窄的应用。方法 回顾性分析2017年6月~2018年6月四川省人民医院收治的78例肝内胆管结石合并胆管良性狭窄患者的临床资料，均行胆道镜联合钬激光治疗，分析其治疗效果。结果 共78例肝内胆管结石合并胆管良性狭窄患者，胆道镜探查148支胆管开口处狭窄，23支胆管狭窄经取石网篮反复扩张改善，125支狭窄胆管开口经钬激光治疗后解除；其中14处狭窄环激光治疗过程中出血，经盐水+肾上腺素局部冲洗，胆道镜头端压迫出血停止，4例出现迟发性胆道出血，给予钬激光止血及对症治疗，狭窄环解除。结论 胆道镜联合钬激光治疗肝内胆管良性狭窄疗效确切，安全、可行、创伤小。

Application of Choledochoscopy Combined with Holmium Laser in Benign Stenosis of Intrahepatic Bile Duct after Biliary Tract Operation

Objective To investigate the effect of choledochoscopy combined with holmium laser on benign stenosis of intrahepatic bile duct after biliary tract surgery. Methods The clinical data of 78 patients with intrahepatic bile duct stones complicated with benign biliary stricture admitted to Sichuan Provincial People's Hospital from June 2017 to June 2018 were retrospectively analyzed. All patients underwent choledochoscopy combined with holmium laser treatment. Results A total of 78 patients with intrahepatic bile duct stones complicated with benign biliary stenosis, biliary tract stenosis 148 biliary stenosis, 23 bile duct stenosis were repeatedly expanded by stone basket, and 125 stenotic bile duct openings were relieved by holmium laser treatment; Among them, 14 stenosis of the ring laser treatment, local flushing by saline + adrenaline, biliary end oppression bleeding stopped, 4 cases of delayed biliary bleeding, holmium laser hemostasis and symptomatic treatment, stenosis ring relief. Conclusion Cholangioscopic combined with holmium laser is effective, safe, feasible and less invasive in the treatment of benign intrahepatic bile duct stricture.