摘要
目的探讨一次性胆道镜治疗胆管结石的临床疗效和应用价值。方法回顾性分析2023年10月至2024年6月南京医科大学第一附属医院采用胆道镜完成取石治疗的135例胆管结石患者的临床资料,其中50例采用一次性胆道镜,85例采用重复胆道镜。两组患者在行经窦道胆道镜取石治疗前,经胆总管探查T管引流术,或经皮肝穿刺胆管引流术,或开腹胆总管探查T管引流术等完成窦道构建。对比分析两组患者一般资料和术中术后指标。结果所有患者均顺利完成经窦道胆道镜取石治疗。两组患者一般资料、胆道镜取石时机(手术留置管道至行胆道镜手术的时间)、血常规和肝功能指标比较差异均无统计学意义(均P>0.05)。一次性胆道镜组较重复胆道镜组取石时间更长[(31.18±7.68)min vs(26.72±10.15)min,t=2.883,P=0.005],但结石残余率更低[2.0%(1/50)vs 11.8%(10/85),χ^(2)=4.011,P=0.040]。结论一次性胆道镜能够探及更细小的胆管分支,结石残余率降低,但取石时间增加,具有良好的临床应用价值。
Objective To investigate the clinical efficacy and application value of single-use choledochoscope in treating bile duct stones.Methods Clinical data of 135 patients with bile duct stones who underwent stone extraction via choledochoscope at the First Affiliated Hospital of Nanjing Medical University between Oct.2023 and Jun.2024 were retrospectively analyzed.Among them,50 patients received single-use choledochoscope,and 85 received reusable choledochoscope.Prior to choledochoscopic stone extraction via sinus tract,sinus tract formation was achieved through procedures including common bile duct exploration with T-tube drainage,percutaneous transhepatic cholangiography and drainage,or open common bile duct exploration with T-tube drainage.General patient data and intraoperative/postoperative indicators were compared between the two groups.Results All patients successfully completed the choledochoscopic stone extraction via sinus tract.No significant differences were observed in general patient data,timing of choledochoscopy(interval between tube placement and choledochoscopic surgery),or hematological and liver function indicators between the two groups(all P>0.05).Compared with the reusable choledochoscope group,the single-use choledochoscope group had a longer stone extraction time[(31.18±7.68)min vs(26.72±10.15)min,t=2.883,P=0.005],but a lower residual stone rate[2.0%(1/50)vs 11.8%(10/85),χ^(2)=4.011,P=0.040].Conclusion Single-use choledochoscope can access finer biliary branches,thereby reducing the residual stone rate,although it increases operation time,demonstrating good clinical value.
作者
胡元昌
石毅
白剑峰
高骥
HU Yuanchang;SHI Yi;BAI Jianfeng;GAO Ji(Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)
出处
《肝胆胰外科杂志》
2025年第8期529-532,538,共5页
Journal of Hepatopancreatobiliary Surgery
关键词
一次性胆道镜
重复胆道镜
胆管结石
取石时间
结石残留
single-use choledochoscope
reusable choledochoscope
bile duct stone
stone extraction time
stone residue
