中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2015年
4期
339-340,346
,共3页
胆总管结石%胆道镜%钬激光%胆囊管
膽總管結石%膽道鏡%鈥激光%膽囊管
담총관결석%담도경%화격광%담낭관
Choledocholithiasis%Choledochoscopy%Holmium laser%Cystic duct
目的：探讨胆道镜联合钬激光经胆囊管治疗胆总管结石的价值。方法2012年3月～2013年12月采用胆道镜联合钬激光经胆囊管治疗16例胆总管结石。钬激光功率为1．0 J／10 Hz，光导纤维直径为400μm，光导纤维通过胆道镜工作通道，在直视下接触结石，将结石击碎后注水冲出或通过套石篮取出。结果15例胆道镜联合钬激光经胆囊管碎石术成功，其中腹腔镜下完成6例，开腹9例。开腹手术时间（132±27）min，腹腔镜手术时间（156±33）min；开腹碎石加取石时间（30．2±8．5）min；腹腔镜下（45．6±10．4）min。住院（9．7±1．4）d。1例胆总管下段充满型结石碎石失败，由于不能形成通.水流，视野模糊。14例随访2～24个月，（14±3）月，无结石复发和胆道狭窄。结论经胆囊管钬激光碎石术具有直观、准确、疗效确切的特点，是治疗胆总管结石的一种安全、有效的新手段。
目的：探討膽道鏡聯閤鈥激光經膽囊管治療膽總管結石的價值。方法2012年3月～2013年12月採用膽道鏡聯閤鈥激光經膽囊管治療16例膽總管結石。鈥激光功率為1．0 J／10 Hz，光導纖維直徑為400μm，光導纖維通過膽道鏡工作通道，在直視下接觸結石，將結石擊碎後註水遲齣或通過套石籃取齣。結果15例膽道鏡聯閤鈥激光經膽囊管碎石術成功，其中腹腔鏡下完成6例，開腹9例。開腹手術時間（132±27）min，腹腔鏡手術時間（156±33）min；開腹碎石加取石時間（30．2±8．5）min；腹腔鏡下（45．6±10．4）min。住院（9．7±1．4）d。1例膽總管下段充滿型結石碎石失敗，由于不能形成通.水流，視野模糊。14例隨訪2～24箇月，（14±3）月，無結石複髮和膽道狹窄。結論經膽囊管鈥激光碎石術具有直觀、準確、療效確切的特點，是治療膽總管結石的一種安全、有效的新手段。
목적：탐토담도경연합화격광경담낭관치료담총관결석적개치。방법2012년3월～2013년12월채용담도경연합화격광경담낭관치료16례담총관결석。화격광공솔위1．0 J／10 Hz，광도섬유직경위400μm，광도섬유통과담도경공작통도，재직시하접촉결석，장결석격쇄후주수충출혹통과투석람취출。결과15례담도경연합화격광경담낭관쇄석술성공，기중복강경하완성6례，개복9례。개복수술시간（132±27）min，복강경수술시간（156±33）min；개복쇄석가취석시간（30．2±8．5）min；복강경하（45．6±10．4）min。주원（9．7±1．4）d。1례담총관하단충만형결석쇄석실패，유우불능형성통.수류，시야모호。14례수방2～24개월，（14±3）월，무결석복발화담도협착。결론경담낭관화격광쇄석술구유직관、준학、료효학절적특점，시치료담총관결석적일충안전、유효적신수단。
Objective To investigate the application value of transcystic choledochoscopy combined with holmium laser for common bile duct stones . Methods Clinical data of 16 patients with common bile duct stones who underwent transcystic choledochoscopy and holmium laser cholelithotripsy between March 2012 and December 2013 in this hospital were retrospectively analyzed.During holmium laser cholelithotripsy (1.0 J/10 Hz, 400 μm fiber), the stones were fragmented under direct vision of choledochoscopy and were extracted by using water flushing or a stone basket . Results The stones were successfully removed in 15 patients, including 6 cases of laparoscopic operation and 9 cases of open operation .The operation time was (132 ±27) min for open surgery and (156 ±33) min for laparoscopic surgery .The stone fragment and removal time was (30.2 ±8.5) min for open surgery and (45.6 ±10.4) min for laparoscopic surgery .The hospital stay was (9.7 ±1.4) d.There was 1 case of failed cholelithotripsy due to obstructed water flow and blurry vision .Follow-up examinations in 14 cases for 2-24 months found no recurrence of stones or biliary strictures. Conclusion Transcystic choledochoscopy and holmium laser cholelithotripsy is intuitive , accurate, and effective, being a safe and reliable alternative for choledocholithiasis .
