中国实用外科杂志2017，Vol.37Issue(8)：896-899,4.DOI:10.19538/j.cjps.issn1005-2208.2017.08.16
经皮经肝胆道镜硬镜碎石术治疗肝内胆管结石194例临床疗效分析
Clinical effective analysis of percutaneous transhepatic cholangioscopic lithotrip by rigid choledochoscopy for 194 patients with intrahepatic stones
蒋小峰 1张大伟 1卢海武 1温子龙 1郑强 1刘颂航 1杨学伟 1曹良启 1薛平1
作者信息
- 1. 广州医科大学附属第二医院肝胆胰外科,广东广州 510260
- 折叠
摘要
Abstract
Objective To investigate the clinical application of percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) for intrahepatic stones. Methods The clinical data of 194 patients with complicate intrahepatic stone performed PTCSL between February 1, 2008 and December 31, 2016 in Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical University were analyzed retrospectively. The procedure was divided into two groups: one step procedure percutaneous transhepatic cholangial drainage and percutaneous transhepatic cholangioscopy were performed simultaneously; Two step procedure percutaneous transhepatic cholangioscopy was performed 3-5 days after percutaneous transhepatic cholangial drainage. Results All the patients were successfully performed by percutaneous transhepatic cholangioscopy. The one step procedure was performed in 28 patients(14.4%), while two step procedure 166 patients(85.6%). Operation time was(45.0 ± 8.0)min. Saline solution used for rinse was (6000.0±500.0)mL. The stone clearance status:intrahepatic stones were all removed in 81 patients(41.8%). Incomplete removal was achieved in 113 patients (58.2%), of which 109 patients of secondary bile duct branch without residual stones. Postoperative complications included 13 patients(6.7%)with biliary tract infection and 5 patients(2.6%)with bleeding. Two patients developed into infection shock and one patient died of multiple organ failure. One hundred and sixty-tow patients (83.5%) were followed up, and the overall recurrence rate for hepatolithiasis in patients who underwent PTCS therapy was 29.6%(48/162). Conclusion PTCSL is effective in the treatment of selected patients with intrahepatic bile duct stones. Combination of stiff and soft cholangioscopy can reduce the possibility of retaining stones after operation. Compared with one step procedure, two step procedure may result in fewer serious complications.关键词
经皮经肝胆道镜/硬质胆道镜/肝内胆管结石Key words
percutaneous transhepatic cholan-gioscopy/rigid choledochoscopy/intrahepatic stones分类
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蒋小峰,张大伟,卢海武,温子龙,郑强,刘颂航,杨学伟,曹良启,薛平..经皮经肝胆道镜硬镜碎石术治疗肝内胆管结石194例临床疗效分析[J].中国实用外科杂志,2017,37(8):896-899,4.
