冷激光联合胆道镜治疗胆道术后残余结石效果分析

江哲龙; 潘凡; 吕立志; 江艺

doi:10.3969/j.issn.1001-5256.2016.11.027

冷激光联合胆道镜治疗胆道术后残余结石效果分析

DOI: 10.3969/j.issn.1001-5256.2016.11.027

南京军区福州总医院肝胆外科

基金项目:

南京军区面上课题(15MS136)；福建省自然基金项目面上课题(2016J01592)；南京军区福州总医院院内课题(2014J08)；

详细信息

中图分类号: R657.42
计量
- 文章访问数: 2017
- HTML全文浏览量: 33
- PDF下载量: 449
- 被引次数: 0
出版历程
- 出版日期: 2016-11-20

Value of cold laser combined with choledochoscopy in treatment of residual stones after biliary surgery

Research funding:

摘要

摘要: 目的探讨冷激光联合胆道镜在胆道术后残余结石治疗中的应用价值。方法回顾性分析2015年1月-2016年6月南京军区福州总医院收治的79例胆道术后残余结石患者的临床资料,所有患者均在术后6周行冷激光联合胆道镜治疗,观察治愈率及并发症情况。结果 79例患者均碎石成功,治愈率100%。68例未出现术后并发症;7例术后出现腹胀、腹痛、腹泻,观察后自行缓解;4例术后出现畏冷、寒颤,对症治疗后症状好转。均未出现胆管损伤、胆道穿孔、胆漏、胆道出血等严重并发症。结论冷激光联合胆道镜治疗胆道术后残余结石效果好、安全性高、可重复性强,值得临床推广。
- 胆结石 /
- 内窥镜检查,消化系统 /
- 碎石术,激光
Abstract: Objective To investigate the value of cold laser combined with choledochoscopy in the treatment of residual stones after biliary surgery. Methods A retrospective analysis was performed for the clinical data of 79 patients with residual stones after biliary surgery who were admitted to Fuzhou General Hospital of Nanjing Military Area Command from January 2015 to June 2016. All the patients underwent cold laser combined with choledochoscopy at 6 weeks after surgery. The cure rate and complications were observed. Results All the patients underwent successful lithotripsy,and the cure rate was 100%. Of all the patients,68 did not experience any postoperative complication,7 experienced abdominal distension,abdominal pain,and diarrhea,which achieved spontaneous remission after observation,and 4 experienced fear of cold and chill,which were improved after symptomatic treatment. No patients experienced serious complications,such as bile duct injury,biliary tract perforation,bile leakage,and hematobilia. Conclusion Cold laser combined with choledochoscopy has a good effect,a high level of safety,and good repeatability in the treatment of residual stones after biliary surgery; therefore,it holds promise for clinical application.
- cholelithiasis /
- endoscopy,digestive system /
- lithotripsy,laser

HTML全文

参考文献(15)

[1]CHEN XP.Chirurgery[M].Beijing:People's Medical Publishing House,2005:674.(in Chinese)陈孝平.外科学[M].北京:人民卫生出版社,2005:674.

[2]HAN Q,DENG HY,ZHUANG LZ,et al.Clinical application of fiber choledochoscope in treatment of retained biliary tract stones:an analysis of 573 cases[J].J Clin Hepatol,2013,29(6):414-417.(in Chinese)韩庆,邓浩源,庄礼钊,等.纤维胆道镜治疗胆道残余结石573例临床分析[J].临床肝胆病杂志,2013,29(6):414-417.

[3]DEGIRMENCI T,GUNLUSOY B,KOZACIOGLU Z,et al.Comparison of Ho:YAG laser and pneumatic lithotripsy in the treatment of impacted ureteral stones:an analysis of risk factors[J].Kaohsiung J Med Sci,2014,30(3):153-158.

[4]ZHOU HJ,SHEN B,XIAO WX,et al.Clinical effect of hepalobectomy combined with choledochoscopy in treatment of complex primary intrahepatic bile duct stone[J].J Hepatopancreatobiliary Surg,2016,28(2):133-134.(in Chinese)周海军,沈彬,肖卫星,等.肝叶切除术联合胆道镜治疗复杂原发性肝内胆管结石[J].肝胆胰外科杂志,2016,28(2):133-134.

[5]CHEN YT,LIN LJ,SHI Z,et al.Clinical application of choledochoscopy in treat ment of postoperative residual bile duct stones[J].Chin J Gen Surg,2009,18(8):779-781.(in Chinese)陈有挺,林丽娟,石铮,等.胆道镜在治疗胆道术后残余结石的应用[J].中国普通外科杂志,2009,18(8):779-781.

[6]SIONIS S,CARIA RA,TRUCAS M,et al.Sialoendoscopy with and without holmium:YAG laser-assisted lithotripsy in the man-agement of obstructive sialadenitis of major salivary glands[J].Br J Oral Maxil ofac Surg,2014,52(1):58-62.

[7]HUANG ZQ.Biliary surgery:Intrahepatic bile duct stones[M].Beijing:People's Military Medical Press,2010:129-130.(in Chinese)黄志强.胆道外科手术学:肝内胆管结石[M].北京:人民军医出版社,2010:129-130.

[8] TONG L,DENG XP,XIE K,et al.Reasons and prognosis of multiple-operations for intra-and extrahepatic cholangiolithiasis[J].Chin J Digest Surg,2016,15(4):368-373.(in Chinese)童里,耿小平,谢坤,等.肝内外胆管结石多次手术原因及预后分析[J].中华消化外科杂志,2016,15(4):368-373.

[9]DAI JS,DENG ZB,YAN DG,et al.Experience in diagnosis and treatment of residual stones after biliary surgery:an alalysis of 261 cases[J].J Hepatopancreatobiliary Surg,2015,27(4):318-320.(in Chinese)代劲松,邓志波,颜登高,等.胆道术后残余结石261例诊疗体会[J].肝胆胰外科杂志,2015,27(4):318-320.

[10]MULTESCU R,GEAVLETE B,GEORGESCU D,et al.Holmium laser intrarenal lithotripsy in pyelocaliceal lithiasis treatment:to dust or to extractable fragments?[J].Chirurgia(Bucur),2014,109(1):95-98.

[11]HE XD,LIU QF.Diagnosis and treatment of hepatolithiasis[J].Chin J Dig Surg,2015,14(4):275-279.(in Chinese)何小东,刘乔飞.肝胆管结石病的诊断与治疗[J].中华消化外科杂志,2015,14(4):275-279.

[12]BUTT Z,HYDER Q.Cholelithiasis in hepatic cirrhosis:evaluating the role of risk factors[J].J Pak Med Assoc,2010,60(8):641-644.

[13] XIAO XL,ZHOU L,ZHONG DW,et al.Clinical effect of choledochoscopy combined with holmium laser lithotripsy in the treatment of hepatolithiasis[J].China Modern Med,2015,22(31):33-35.(in Chinese)肖修林,周林,钟鼎文,等.胆道镜联合钬激光碎石术治疗肝内胆管结石效果分析[J].中国当代医药,2015,22(31):33-35.

[14]BADER MJ,GRATZKE C,HEEHT V,et al.Impact of collateral damage to endourologic tools during laser lithotripsy--in vitro comparison of three diferent clinical laser systems[J].J Endourol,2011,25(4):667-672.

[15]LIU F,JIN ZD,ZOU DW,et al.Efficacy and safety of endoscopic biliary lithotripsy using FREDDY laser with a radiopaque mark under fluoroscopic guidance.[J].Endoscopy,2011,43(11):918-921.

施引文献

资源附件(0)

访问统计