CAJ | 학술논문

目的：探讨经十二指肠镜逆行取石(ERCP)与经皮肝胆道镜顺行取石(PTCS)联合治疗胆总管结石合并肝胆管结石的疗效。方法对25例胆总管结石合并肝胆管结石患者行ERCP+PTCS治疗，即在ERCP治疗胆总管结石后即可行经皮肝穿刺胆道造瘘术，术后5~7天行经瘘道胆道镜取石术。总结临床资料，并与同期27例行胆总管切开胆道镜探查取石治疗的患者资料对比分析。结果ERCP与PTCS术联合治疗胆总管结石合并肝内胆管结石25例，结石取净率为96.0%，优于对照组的70.4%(P<0.05)；并发症发生率相当，住院时间较短，花费相对较多(P<0.01)。结论ERCP联合PTCS是治疗胆总管结石合并肝胆管结石的安全有效的方法。
목적：탐토경십이지장경역행취석(ERCP)여경피간담도경순행취석(PTCS)연합치료담총관결석합병간담관결석적료효。방법대25례담총관결석합병간담관결석환자행ERCP+PTCS치료，즉재ERCP치료담총관결석후즉가행경피간천자담도조루술，술후5~7천행경루도담도경취석술。총결림상자료，병여동기27례행담총관절개담도경탐사취석치료적환자자료대비분석。결과ERCP여PTCS술연합치료담총관결석합병간내담관결석25례，결석취정솔위96.0%，우우대조조적70.4%(P<0.05)；병발증발생솔상당，주원시간교단，화비상대교다(P<0.01)。결론ERCP연합PTCS시치료담총관결석합병간담관결석적안전유효적방법。
Objective To discuss the effect of encoscopic retrograde cholangio-pancreatogra (ERCP) and percutaneous transhepatic cholangioscopy (PTCS) in the treatment of choledocholithiasis complicated with hepatolithiasis. Methods 25 patients with choledocholithiasis and hepatolithiasis were treated with ERCP+PTCS (patients received percutaneous transhepatic gastrostomy after ERCP treatment of common bile duct stones, and were treat with fistula choledochofiberscopy 5~7 days after the first surgical operation). The clinical data were compared with 27 patients treated with choledochotomy choledochoscopic lithotomy. Results Among 25 cases of choledocholithiasis and hepatolithiasis treated with ERCP+PTCS, the stone clearance rate was 96.0%, better than 70.4%of control group (P<0.05), with similar complication rate, shorter length of hospital stay and relatively high costs (P >0.05). Conclusions The combination therapy of ERCP and PTCS is a safe and effective way to treat choledocholithiasis and hepatolithiasis.