摘要
作者于１９９Ｏ年１月至１９９２年１０月对５４例取石篮不能取出的胆管残留结石分别行碎石篮碎石（１０例）、压电冲击波碎石（１５例）、液电冲击波碎石（１４例）和经内镜括约肌切开（１５例）治疗。结石的直径５ｍｍ～２５ｍｍ不等。当结石的直径大于Ｔ管窦道时采用碎石篮碎石；机械碎石失败时采用冲击波碎石；胆管结石伴有胆总管下端狭窄、壶腹部嵌顿性结石、位于胆总管未端囊肿内的结石则采用经内镜乳头括约肌切开。碎石后联合应用胆道冲洗、取石篮和胆道镜清除结石碎片，在这四组患者中，结石消失率和再手术率分别为９０％、４６．７％、８５．７％、１００％和１０％、６．６％、１４．３％、０。无严重并发症。非手术疗法联合应用可提高胆管残留结石的治疗成功率。
AbstractBasket lithotriptor,piezoelectric shock wavelithotripsy, electrohydraulic shock wave lithotripsy,and endoscopic papillosphincterotomy were used tomanage respectiyely 10,15,14,and 15 patients withretained intra and extrahepatic bile duct stones thatcould not be removed with a Dormia basket.In thesefour group patients the stones ranged from 5 to 2 5mmin diameter.A residual stone was fragmented with abasket lithotriptor if its diameter exceeded that of the Ttube tract.Shock-wave was used when mechanicallithotripsy was unsuccessful.Endoscopic papillo-sphincterotomy was carried out in patients with steno-sis of the sphincter,or impacted stone at the Ampullaof Vater. Combined biliary lavage,Dormia basket,andcholedochoscopy after lithotripsy accelerated clearanceof fragments. In these four groups,stone-free ratesand reoperation rates were 90,46.7,85.7,and 100percent and 10,6.6,14.3,and 0 percent respectively.There were no serious complications.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1994年第2期100-102,共3页
Chinese Journal of Surgery
