经皮持续灌洗胆镜治疗原发性胆管结石的临床评价

目的 探索经皮持续灌洗胆镜(PCIC)治疗肝内胆管结石及狭窄的可行性及临床价值。方法采用PCIC分别经胆总管切开入路，左肝外侧叶切除后断面胆管入路，T管瘘道，小剖腹左肝胆管入路及胆肠Roux-en-Y吻合皮下肠袢等多途径治疗原发性胆管结石372例。结果 经上述途径入镜，结石取净牢分别为99％，100％，97％，100％及100％。总的结石取净率为99．2％。对94例合并胆管狭窄病人，经PCIC即时扩张或扩张加支撑管治疗，狭窄全部解除。随访15个月至6年，无症状及结石复发。结论 PCIC治疗原发性胆管结石方法简便，疗效肯定。

Clinical evaluation on treatment of primary cholelithes with percutaneous continuous irrigation cholelitho-scope

Objective To study the feasibility and clinical value of percutaneous continuous irrigation cholelithoscope (PCIC) in treatment of cholelithes bile duct stricture in the liver. Methods A total of 372 patients with primary cholelithes were treated with PCIC in our hospital. The routes for insertion of PCIC were incision on the choleduches, hepatic duct of the cross-section after left lateral lobectomy of the liver, T-tube fistula, the left hepatic duct following lesser laparotomy and the blind-loop of Roux-en-Y choledochojejunostomy. Results The stone-clearing rate was 99%, 100%, 97%, 100% and 100%, respectively, with insertion through the above-mentioned routes and the average rate was 99.2%. Ninety-four patients complicated with stricture of bile duct were treated with PCIC plus dilation with supporting-tube. All the strictures were released. The follow-up check for 15 months to 6 years showed no symptoms or recurrence. Conclusions PCIC is convenient in treating primary cholelithes and has definite therapeutic effects.