术中B超联合纤维胆道镜在肝胆管 结石手术治疗中的应用

The treatment of hepatolithiasis with intraoperative ultrasound combined with choledochoscope

摘要:

目的 探讨术中B超联合纤维胆道镜在肝胆管结石手术治疗中的临床应用价值。方法 回顾性总结分析我院2013年1月-2013年12月收治的44例较复杂肝胆管结石患者在手术中应用B超联合纤维胆道镜进行外科治疗。结果 术后无胆漏、腹腔出血及肝功能衰竭等并发症发生；无死亡病例，均治愈出院。术后8周常规行T管造影或B超复查，发现胆管残余结石2例，采用经T管窦道胆道镜检查，使用纤维胆道镜配合网篮取出残余结石。结论 术中B超配合纤维胆道镜可以降低传统经胆总管切开取石的盲目性，有效减少术后结石的残留，在治疗肝胆管结石疾病上有重要的临床推广价值。

Abstract:

【Objective】 To assess the effectiveness of the intraoperative ultrasound and choledochoscope which were applied in the surgical treatment of hepatolithiasis. 【Methods】 The outcomes of 44 cases with hepatolithiasis who were treated by the intraoperative ultrasound and choledochoscope in the operation were retrospectively analyzed. 【Results】 The complications of bile leak, abdominal hemorrhage and hepatic failure didn't occurred postoperation. No death occurred. T-tube cholangiography and B ultrasound were performed after 8 weeks. 2 cases had occurred residual calculus. These cases were treated by the choledochoscope and the residual calculus were extracted by the basket. 【Conclusion】 The blindness of the traditional surgical treatment as the lithotomy could be reduced by applying the intraoperative ultrasound and choledochoscope in the operation. The occurrence of residual biliary calculus would be decreased significantly, and the value of this surgical technology would become important in the clinical treatment.