术中胆道镜检的价值及入路选择

目的 探讨术中纤维胆道旬检入路的可行性及应用价值。方法 回顾分析本院１９９３年１０月至１９９８年１２月间术中应用纤维胆道镜检１４８例，其中胆总管入路１０８例，胆囊管入路２０例，胆囊管胆总管汇合部入路２６例。结果 肝外胆管结石１０３例，结石取净率１００％，肝内胆管结石１８例，术中取净１０例，残留结石率３７．５％；协助取活检１７例，肝门部胆管癌５例，胆总管下段癌８例，炎性病变４例；阴性探查６例。结论

Intraoperative fibrocholangioscopy: its significance & approach

Objective The clinical significance and the approcach of inserting the scope werestudied. Methods 148 patients underwent the examination in our hospital through October 1993 to De-cember 1998. The scope was put into biliary system via common bile duct (CBD) in 108 cases, cystic duct in20 and the confluence of the two in 26. Results Extrahepatic stones were found in 103 cases with totalextirpation, while the intrahepatic ones were removed in only 10 out of 18 cases ( rate of residual stone =37.5% ). Biopsies were taken in 17 cases with a detection of biliary cancer (n = 5), CBD malignancy (n =8) and inflammatory change (n = 4). Conclusion The application of intraoperative cholangioscopy offersready reduction of residual stone and correct diagnosis with biopsy. The scope can be passed through cysticduct, CBD or their junction, depending on real conditions.