经胆囊管胆道镜探查取石27例

目的：探讨胆囊切除术中经胆囊管纤维胆道镜检查、取石对继发性胆总管结石的治疗价值。方法：对27例有胆总管探查指征、高度怀疑有胆总管继发性结石的患者，在胆囊切除术中经胆囊管用胆道镜探查并清除结石。结果：10例探查阴性，17例发现胆总管下端结石，1例伴左肝管开口部结石，直径4～6mm。12例以取石网套取后，自胆囊管取出；2例结石碎裂后，分次取出；3例以活检钳置操作孔内，用胆道镜将结石推入十二指肠。全组无并发症，术后平均9天出院。结论：经胆囊管胆道镜探查取石。可作为治疗胆总管继发性结石的首选方法。

Choledochoscopy for calculi extraction through ductus cysticus:Analysis of 27 cases

Objective:To evaluate the therapeutic value of choledochofiberscope in calculi extraction and examination for secondary common bile duct(CBD) stone through cystic duct during the operation.Methods:Twenty seven patients having the sign of choledochotomy by exploration were treated with endoscope to get rid of the stones during the cholecystectomy.Results:The exploration was negative in 10 cases and stones were found at the inferior extremity of CBD in 17 cases.One case was accompanied by stones at the left hepatic duct.The average diameter of the stone was 4 to 6 mm.Stones were taken out of CBD by grasping basket through cystic duct in 12 cases,stones were broken to pieces and then taken out in 2 cases and stones were pushed into duodenum by endoscope in 3 cases.No complication occurred and the average discharge time after operation was 9 days.Conclusions:It may be the first method for treatment of secondary CBD stone with choledochoscope in calculi extraction through cystic duct.