摘要
目的:探讨双镜(腹腔镜+胆道硬镜)下钬激光碎石治疗肝内外胆管结石的临床应用。方法:回顾性分析2015年12月—2018年12月应用双镜下钬激光碎石治疗肝内外胆管结石120例患者的临床资料。结果:115例在双镜下钬激光碎石成功,5例中转开腹钬激光碎石。手术时间70~185 min,平均(128.5±33.7)min;术中出血量为10~75 mL,平均(51.2±17.1)mL。术后5例发现少量残余结石。106例术后随访2~24个月,平均(15.0±4.8)个月,3例结石残留和复发,经胆道镜检查取出。术后2个月经T型管造影或B超、CT检查,无结石残留给予拔除T型管。结论:双镜下钬激光碎石是治疗肝内外胆管结石的一种安全有效的方式,适合基层医院作为微创技术推广。
Objective:To investigate the value of clinical use of application holmium laser lithotripsy under two endoscopics(laparoscopy+hardcholedochoscope)in the treatment of intrahepatic and extrahepatic bile duct stones.Method:The clinical data were retrospectively analyzed for 120 patients,with intrahepatic and extrahepatic bile duct stones treated by holmium laser lithotripsyundertwo endoscopics,from December 2015 to December 2018.Results:Holmium laser lithotripsy was successfully performed in 115 cases undertwo endoscopics,andthe other 5 cases wasopened the abdomen.The time of operationwas(128.5±33.7)mins,and intraoperative blood losswas(51.2±17.1)mL.A small amount of residual stones was found in 5 patients during postoperative.106 cases were followed up for(15.0±4.8)months after operation,3 cases of residual and recurrent stones were removed by choledochoscopy during the follow-up.The T-tube was pulled out at 2 months after operation,and no residual stones were removed by T-tube cholangiography,or B-ultrasound and CT examination.Conclusion:Holmium laser lithotripsy under two endoscopics is a safe and effective way to treat intrahepatic and extrahepatic bile duct stones,it was suitable for grassroots hospitals as minimally invasive appropriate technology promotion.
作者
成正军
赵晨晖
王亚峰
刘波
CHENG Zheng-Jun;ZHAO Chen-hui;WANG Ya-feng;LIU Bo(Department of Hepatobiliary Surgery,The Second People’s Hospital of Jiulongpo District,Chongqing 400052,China;Mental Health Center of Jiulongpo District,Chongqing 400052,China)
出处
《中国现代普通外科进展》
CAS
2020年第3期186-189,共4页
Chinese Journal of Current Advances in General Surgery
关键词
肝内外胆管结石
腹腔镜
胆道硬镜
钬激光
碎石
Intrahepatic and extrahepatic bile duct stones
Laparoscope
Hard choledochoscope
Holmiumlaser
Lithotripsy
