术后纤维胆道镜治疗胆道残余结石失败析因

１９８２～１９９８年应用纤维胆道残余结石１７２５例，失败１２８例，占７．４２％。肝内胆管巨大嵌顿结石或（和）肝内胆管管真性狭窄、残余结石位于肝脏边缘，术中“Ｔ’一置安放不当，“Ｔ”管脱落致瘘道闭塞和病人不原坚持而中止取石治疗是造成胆镜取石失败的主要原因。强调应特别重视肝内胆管病变的处理，尽可能水中取尽结石，并对术后取石的困难和技巧进行了分析，提出了相应的对策。

AN ANALYSIS ON THE FAILURE CAUSES IN THE TREATMENT OF RESIDUAL STONE WITH FIBROCHOLEDOCHOSCOPY

From 1982 to 1998, 128 cases failed to be cured for residual stones of biliary tract in 1725 patients treated by fibrocholedochoscope. The rate of lithotomy failure was 7.42% (128/1725). The main causes of this failure were huge and embeded stone and/or with true stenosis of intrahepatic biliary duct, residual stones being at the edge of liver, the incorrect place of T-tube, the fall-off of the T-tube and the patients giving up further clearance of residual stones in intrahepatic bile duct. The authors emphasize that it is very important to make a point of the right treatment for intrahepatic bile duct lesions and eliminate the stone during the operation as far as possible. The difficulty and the technique of postoperative lithotomy under choledochoscope are analyzed and some advice is given in this paper.