摘要
目的 探讨钬激光碎石术治疗胆道结石的疗效及安全性。 方法 纤维胆道镜直视下用钬激光碎石治疗肝内胆管结石和胆道术后残余结石 17例。 结果 17例经T管造影及术中胆道造影证实共有 36枚结石。不用钬激光直接取出 7枚结石 ;经钬激光碎石取出 2 4枚结石 ,成功率 82 8% (2 4 2 9) ;余 5枚结石在 3级胆管以上 ,胆道镜无法直接观察到 ,未作钬激光治疗。术后 1月B超及胆道造影未见肝外胆道内残余结石 ,未作治疗的肝内胆管结石仍在原位。全部病例无胆道出血、胆漏、肝功能损害等并发症。T管拔除后随访半年 ,总胆管内未发现残余结石 ,无胆管扩张及胆管炎征象 ,肝功能检查无异常。 结论 在纤维胆道镜直视下用钬激光碎石治疗肝内胆管结石和胆道术后残余结石 ,结石清除率可达 82 8% ,有效、安全。
Objective To evaluate the efficacy and safety of holmium laser lithotripsy in the management of cholelithiasis. Methods 17 patients with hepatolithiasis or residual stones after bile duct operation were treated by holmium lithotripsy under fibrocholedochoscope. Results 36 stones were confirmed in 17 patients by intraoperative cholangiography. 7 stones were removed directly, 24 ones by laser lithotripsy, with success rate being 82 8%(24/29). Due to located in superior segmental intrahepatic duct, other 5 stones could not be observed under fibrocholedochoscope, so they weren't treated by holmium laser lithotripsy. B ultrasoundgraphy and cholangiography showed no residual stones in extrahepatic bile duct at the 1st month postoperatively, and the untreated 5 stones were in the same place. No hemorrhage, bile leakage, liver dysfunction or other complications occurred. Conclusions Holmium laser lithotripsy under fibrocholedochoscope is an effective and safe method in the management of hepatolithiasis or residual stones after bile duct operation.
出处
《中国微创外科杂志》
CSCD
2003年第1期61-62,共2页
Chinese Journal of Minimally Invasive Surgery
