纤维胆道镜在上尿路结石手术中的应用

目的:探讨纤维胆道镜在上尿路结石手术中的应用价值。方法:为31例复杂上尿路结石(多发肾结石、输尿管多发结石、输尿管结石并肾结石)患者施行手术,5例输尿管切开取石术中结石移位时应用纤维胆道镜协助取石。结果:35例取石成功,1例多发肾结石患者有2颗结石残留于肾盏内,术后2个月体外冲击波碎石术(extracorporeal shock wave lithotripsy,ESWL)治疗后排出,2例输尿管粘膜和1例肾盂粘膜损伤出血。结论:纤维胆道镜用于上尿路结石手术,尤其是复杂性上尿路结石手术,有助于取尽结石,对患者损伤小,是一种安全有效的方法,值得临床推广应用。

The application of choledochofiberscope in ureterolithotomy for upper urinary tract calculi

Objective:To evaluate the significance of choledochofiberscope in the surgical treatment of upper urinary tract calculi.Methods:Thirty-one patients with complex upper urinary tract calculi(multiple renal calculi,multiple ureteral calculi and ureteral combined renal calculi)underwent ureterolithotomy,and ureteral calculi dislocation happened in 5 patients undergoing ureterolithotomy.Choledochofiberscope was applied to help removing ureteral and/or renal stones.Results:Thirty-five patients successfully underwent the operation.Among them one patient had two residual fragments in the renal calyces and excreted the stones two months later after ESWL.Two cases of hemorrhage in uretal mucosa and one case of hemorrhage in pyelic mucosa occurred.Conclusions:It is a safe and reliable method to upper urinary tract calculi with ureterolithotomy and choledochofiberscopy,especially to complex upper urinary tract calculi.It is minimally invasive to patient and help to remove all the stones.The method is worthy of clinical application.