纤维胆道镜联合体外冲击波碎石治疗术后胆管残留大结石

目的　探索纤维胆道镜联合体外冲击波碎石 (ESWL )治疗术后胆管残留大结石的临床效果。方法　对经 T管造影或纤维胆道镜诊疗后判定为难以取除的胆管残留大结石 2 3例 ,均采用体外冲击波碎石后纤维胆道镜取石治疗 ,并对碎石前后血常规、肝功能、血淀粉酶等指标进行比较分析。结果　 1次性碎石取石成功 1 7例 ,2次碎石取石成功 3例 ,3次碎石取石成功 2例 ,中途放弃治疗 1例 ,成功率 95 .6 5 % (2 2 / 2 3)。碎石治疗前后相关检查的变化无显著性差异 (P>0 .0 5 ) ,未出现胆道感染、急性胰腺炎等严重并发症。结论　纤维胆道镜联合体外冲击波碎石是术后胆管残留大结石安全、可行、有效的治疗方法

THE TREATMENT OF BILE DUCT REMAIN BIG STONE BY CHOLEDOCHOSCOPY AND EXTRACORPOREAL SHOCK WAVE LITHORIPSY

Objective To explore the clinical effect of bile duct remain big stone by choledochoscopy and extracorporeal shock wave lithoripsy(ESWL).Methods The final diagnosis was established by T tube cholangiography and choledochoscopy in 23 patients with bile duct remain big stone.All patients were treated with the choledchoscopy after ESWL.Comparison and analysis Blood routine,Liver function,Blood amylas of anterior and subsequence of ESWL.Result The stones of 17 cases were taked out of by one session of ESWL, 3 cases were taked out of by 2 sessions,2 cases were taked out of by 3 sessions and one cases gives up therapy inhalfway.Severity complication of infection of biliary tract and acute pancreatitis and so on don't occurrencs.Conclusion It is safe and efficient to treat bile duct remain big stone by choledochoscopy and ESWL.