| 术中胆道镜技术与肝胆胰术式的合理选择 |
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| 引用本文： | 马利林 陈玉泉 沈洪薰 徐青 陆丽萍. 术中胆道镜技术与肝胆胰术式的合理选择[J]. 中国现代手术学杂志, 1998, 3(1): 13-15 |
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| 作者姓名： | 马利林 陈玉泉 沈洪薰 徐青 陆丽萍 |
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| 作者单位： | 南通医学院附属医院普外科，南通医学院附属医院普外科，南通医学院附属医院普外科，南通医学院附属医院普外科，南通医学院附属医院普外科 南通市 226001，南通市 226001，南通市 226001，南通市 226001，南通市 226001 |
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| 摘 要： | 肝胆胰术中应用胆道镜技术212例。术后胆道残石率从34．5％降低为95％，118例肝内胆管结石中46例术中镜检发现合并肝胆管狭窄，其中16例膜状窄者在术中胆道镜(IOC)指引下施行有效扩张；32例胆总管下端梗阻者经镜检明确诊断(其中取活检24例)。据此施行的9例胰十二指肠切除无1例误切，16例镜检为良性狭窄者随访6月至10年，均存活；18例疑有胆总管结石者经扩大的胆囊管径路镜检，13例无阳性发现而免于胆总管切开。作者认为，IOC技采的应用有利于肝胆胰手术方式的选择，对术前未能确诊的胆总管下端病变，既可避免肿瘤的漏诊漏治，又可免除不必要的、创伤较大的根治性切除手术。
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| 关 键 词： | 术中 胆道镜技术 肝胆胰术式 术式选择 |
INTRA - OPERATIVE CHOLEDOCHOSCOPY HELPS PROPER CHOICE OF OPERATION ON LIVER, BILIARY TRACT AND PANCREAS |
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| Ma Lilin Cheng Yuquan Shen Hongxun et al. INTRA - OPERATIVE CHOLEDOCHOSCOPY HELPS PROPER CHOICE OF OPERATION ON LIVER, BILIARY TRACT AND PANCREAS[J]. Chinese Journal of Modern Operative Surgery, 1998, 3(1): 13-15 |
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| Authors: | Ma Lilin Cheng Yuquan Shen Hongxun et al |
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| Abstract: | In this study, 212 cases of operations on the liver, biliary tract and pancreas underwent intra - operative choledochoscopy ( IOC). Thirty - two cases of obstruction in the lower end of the bile duct were diagnosed by this technic and 9 cases of 32 received right pancreatoduodenectomy according their diagnosis. Fourteen cases avoided choledocholithotomy by means of IOC's exploration through enlarged ductus cysti-cus in 18 cases which were doubted of choledocholithiasis. This paper concludes that IOC is very useful for choosing operative mode on lower choledochus diseases including hepatolithiasis and may change an intricate operative mode to an easier and simpler part. On the other hand, IOC can assuredly avoid leaving out the diagnosis and delaying the treatment of the cancer. |
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| Keywords: | endoscopy digestive system surgery operative intraoperative period choosing of operative mode |
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