摘要
目的探讨内镜下肝内外胆管结石同步治疗方法。方法36例肝内外胆管结石病人,肝外胆管结石予以网篮或(和)气囊取石;肝内胆管结石,通过操作技巧将网篮、气囊送入结石所在分支胆管,尝试取石。结果肝外胆管结石病人27例,25例结石取出,2例未取出;肝内胆管结石病人36例,位于一级分支胆管的多发结石5例(局限于同一分支3例)、单发结石3例结石取出,最多取石3枚,最大结石直径5～6mm。二级以上肝内胆管结石无一取出。结论十二指肠镜下乳头切开取石对肝外胆管结石效果好,对肝内胆管结石取石成功率低,但对一级分支肝内胆管单发或位于同一分支胆管多发较小结石仍不失为一简单、微创、经济、可行方法。多种微创手段联合治疗是肝内外胆管结石治疗的发展方向。
[Objective] To investigate the synchronized endoscopic therapy for intrahepatic and extrahepatic bile duet stones. [Methods] Of the total 36 cases with biliary stones, some stones were extracted by stone basket and/or balloon dilation after endoscopic sphineterotomy （EST）. [Results ] Stones were effectively removed in 25 of the 27 eases with extrahepatic bile duct stones. In 36 cases with intraheptic bile duct stones, multiple stones were completely removed from the fh-st level bile ducts of 5 cases and single stone removed from those of 3 eases, but none of bile duct stones was extracted from the second or third level bile ducts. [Conclusion] EST is an effective procedure for extrahepatic bile duct stones, but not for intrahepatic bile duct stones. But it is a simple, minimally invasive and practical therapy for multiple small bile duct stones and single bile duct stone in the first level bile duct. The bile duct stones can be effectively managed with combined endoscopic therapy, which is attributed to the high successful rate in removing biliary stones and should be popularized in this field.
出处
《中国内镜杂志》
CSCD
北大核心
2009年第7期736-737,共2页
China Journal of Endoscopy
关键词
内镜
肝内外胆管
结石
同步治疗
endoscope
extrahepatic and/or intrahepatic bile ducts stone
therapy
