CAJ | 학술논문

目的探讨胆道镜检查在胆道疾患术式选择中的价值。方法收集术中或联合术后应用胆道镜治疗的胆道疾患182例临床资料，进行分析及总结。结果134例胆管胆石症患者胆道残留结石率从35．2％降至9．7％；30例术中胆道镜发现合并胆管狭窄，其中15例肝胆管膜状狭窄者在胆道镜指导下实施了有效扩张治疗；13例术后残留结石取尽12例；胆总管下段梗阻病史中24例肿瘤依据形态学检查，结合术中扪诊及活检组织学检查得到确诊，并采取了相应的手术方式。结论胆道镜的应用有利于胆道疾患术式的选择，可使一些较为复杂的胆道手术变得简单易行；对术前未能确诊的病变可以达到明确诊断并指导选择合理的术式。
목적 탐토담도경검사재담도질환술식선택중적개치。방법수집술중혹연합술후응용담도경치료적담도질환182례림상자료，진행분석급총결。결과134례담관담석증환자담도잔류결석솔종35．2％강지9．7％；30례술중담도경발현합병담관협착，기중15례간담관막상협착자재담도경지도하실시료유효확장치료；13례술후잔류결석취진12례；담총관하단경조병사중24례종류의거형태학검사，결합술중문진급활검조직학검사득도학진，병채취료상응적수술방식。결론담도경적응용유리우담도질환술식적선택，가사일사교위복잡적담도수술변득간단역행；대술전미능학진적병변가이체도명학진단병지도선택합리적술식。
Objective The significance of intra or postoperative choledochoscopy in selecting propersurgery for biliary disorders was evaluated. Methods The clinical materials of 182 patients undergoingcholedochoscopy were reviewed. Results The rate of residual stones dropped from 35.2 to 9.7 percent in134 cases with choledocholithiasis. With the scopy residual stones were extracted in 12/13 patients , biliarymenbranous stenosis being dilated in 15/30 and the cause of malignant obstruction of lower common bile ductelucidated in 24 instances . Conclusion Intraoperative choledochoscopy is beneficial in the choice of ap-propriate operation for biliary disorders as well as in establishing correct diagnosis that is ambiguous beforesurgery.