术中胆道镜治疗肝内胆管多发结石的临床观察

目的观察治疗肝内胆管多发结石手术中配合胆道镜取石的}】盏床作用和意义。方法抽取2009年4月至2013年3月收治的42例肝内胆管多发结石患者，均需手术器械取石，其中22例患者术中配合应用胆道镜．作为观察组，其余为对照组。比较两组患者术后结石残留情况以及术后状态。结果观察组患者治疗优良率为90．9％（20／22），明显高于对照组的70．0％（14／20），差异具有统计学意义（P〈0．05）；并且含3例结石残留，残留率为13．6％（3／22），明显低于对照组的40．0％（8／20），差异具有显著性（P〈0．05）；观察组术后并发症发生率为22．7％（5／22），显著低于对照组的55．0％（11／20），差异有统计学意义（P〈0．05）。结论术中配合胆道镜取石的实用性较强，有效避免结石残留以及再次手术取石发生，临床认可度高，应用价值明显。

Clinical Observation on Intraoperative Choledochoscopey in the Treatment of Intrahepatic Biliary Calculi

Objective To observe the clinical effect and significance of intraoperative choledochoscopey in the treatment of intrahepatic biliary calculi. Methods Forty-two cases of intrahepatic biliary calculi patients who needed stone removal by instruments fi＇om April 2009 to March 2013 were divided into two groups： the observation group with 22 cases operated with choledochoscopy, and the others were as control group. Postoperative residual stones and postoperative status in two groups were compared. Results The effective rate in observation group was 90.9% （20/22）, significantly higher than that of 70% （14/20） in control group; the difference was statistically significant （P 〈0.05）; in observation group, 3 cases had residual stones, with residual rate of 13.6% （3/22）, which was significantly lower than that of 40%（8/20） in control group; the difference was significant （P 〈0.05）; the postoperative complication rate in observation group was 22.7% （5/22）, significantly lower than that of 55% （11/20） in control group; the difference was statistically significant （P 〈0.05）. Conclusions Intraoperative choledochoscopy is practical and effective in decreasing the residual stones and avoiding second operation. It has high clinical acceptance and obvious application value.