经胆囊管胆总管探查的纤维胆道镜应用

目的 探讨应用胆道镜经胆囊管行胆总管探查的临床价值。方法 应用日本OlympusP20型纤维胆道镜对40例患者于术中实施经胆囊胆总管探查和治疗。结果 19例探查阴性，21例胆总管结石（其中13例合并胆囊结石），12例单纯胆囊结石。全组术后无胆漏和黄疸发生，全部病例恢复顺利。随访半年无残余结石。结论 有胆总管探查指征者均可经胆囊管行纤维胆道镜探查。降低胆道残石的发生率和胆总管切开探查率。手术操作方便安全。

Application of choledochofiberscope to the exploratory operation of choledochus through cystic duct

Objective To study the applied value of choledochofiberscope on the exploratory operation of choledochus through cystic duct.Method 40 patients with cholelithiasis were treated by utilizing choledochofiberscope whose type is Olympus P 20 (made in Japan),and the exploratory operations of choledochus and the choledocholithotomy through cystic duct were performed.Result After exploration with choledochofiberscope, 19 cases were negative, whereas, 21 cases were found to be choledocholithiasis, including 13 cases which were combined with cholecystolithiasis. There were no patients who suffered from postoperative bile leakage and jaundice. All cases recovered quickly and well. No residual choledocholithia was detected in any patients in the half-year follow-up survey. Conclusion Any patients who have the indication of choledochotomy with exploration may also have the indication of the exploratory operation of choledochus through cystic duct by choledochofiberscope. This technique can reduce the chance of residual choledocholith remaining and the incidence of choledochotomy with exploration.