纤维胆道镜在肝胆管结石治疗中的价值

目的 探讨手术和纤胆镜联合治疗肝胆管结石的应用价值。方法 回顾分析1998年9月～2003年6月共380例手术和纤胆镜联合治疗肝胆管结石病人的临床资料。结果 380例肝胆管结石病人术中应用纤胆镜技术后。残留结石率由38％降到12．9％,132例术中纤胆镜发现合并肝内胆管狭窄，其中30例为假性狭窄，经纤胆镜扩张后治愈，其余采用了相应的手术方式。49例残留结石的病人术后均采用纤胆镜取石，残留结石率为1．9％，4例因多次取石费用高而放弃，3例因胆道出血而放弃。结论 肝胆管结石的手术中联合应用纤胆镜可使肝内结石的诊断更明确、取石更有效，并对手术方式的选择有指导意义，术后经T管窦道纤胆镜取石是治疗肝H日管残留结石的的主要手段.

THE SIGNIFICANCE OF INTRAOPERATIVE AND POSTOPERATIVE CHOLEDOCHOSCOPY IN TREATMENT AND DIAGNOSIS OF HEPATOLITHIASIS

Objective To study the significance of intraoperative and postoperative choledochoscopy in treatment and diagnosis of hepatolithiasis.Methods Altogether 380 cases of hepatolithoasis with surgical operation and choledochoscopy were reviewed during 1998.9 to 2003.6.Result Attributed to systemic therapy of choledochoscopy,the residual stone rate of operation was decreased from 38% to 12.9%,intra operative choledochoscopy found 132 cases hepatolithiasis accompanied with bile stricture,with the scopy biliary menbranous stenosis were dilated in 30/132,the residual stones being extracted in 7/49.Conclusion In traoperative choledochoscopy is beneficial in the choice of appropriate operation for biliary disorders as well as in establishing correct diagnosis that is ambiguous before surgery.Postoperative choledochoscopy is an important methods for decreasing the residual stone rate.