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目的探讨胆道镜在胰管结石手术治疗中的应用价值。方法回顾性分析2004年1月至2009年9月中国医科大学附属盛京医院在胰管切开取石联合胰管空肠Roux-en-Y吻合手术中应用胆道镜治疗9例胰管结石(胆道镜取石组),并与2003年1月至2009年9月仅行常规胰管切开取石联合胰管空肠Roux-en-Y吻合术治疗12例胰管结石(常规手术组)进行比较。结果胆道镜取石组术中出血量(233.3±55.9)mL,显著低于常规手术组[(583.0±135.4)mL,t=5.448,P=0.031]。术后残石率胆道镜取石组显著低于常规手术组(0 vs.41.7%,P=0.045)。术后疼痛缓解率胆道镜取石组(88.9%)高于常规手术组(50.0%),但差异无统计学意义(P=0.159)。结论在胰管结石手术中使用胆道镜取石技术能显著提高结石取净率和减少术中出血量,有可能提高术后疼痛缓解率。

Application of choledochoscopy in pancreatolithiasis

Objective To evaluate the clinical value of choledochoscopy for the treatment of pancreatolithiasis.Methods From January 2004 to September 2009,choledochoscopy was used in 9 patients with pancreatolithiasis during a dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis(choledochoscopy group) in Shengjing Hospital of China Medical University.The data of choledochoscopy group were compared with the data of 12 patients with pancreatolithiasis treated by routine dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis from January 2003 to September 2009(Routine group).Results The intraoperative blood loss and the postoperative rate of residual stones in the choledo-choscopy group were significantly less than those in the routine group [(233.3±55.9)mL vs.(583.0±135.4)mL,(t = 5.448,P =0.031);and(0 vs.41.7%,P = 0.045)].The postoperative rate of pain relief in the choledochoscopy group was higher than that in the routine group(88.9% vs.50.0%).However the difference was not significant(P=0.159).Conclusion Choledochoscopy is effective for the treatment of pancreatolithiasis.The procedure can increase the rate of stone removal,decrease the intraoperative blood loss and elevate the postoperative rate of pain relief.