顺逆结合治疗胆总管结石合并肝胆管结石的临床分析-论文.pdf

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1、临京医学工程2014年8月第21卷第8期·l005··论著·(临床研究)顺逆结合治疗胆总管结石合并肝胆管结石的临床分析丁新民，林树文，袁智明，万里鹏，吉成岗[广东省东莞市太平人民医院肝胆(微创)外科，广东东莞523900]【摘要】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PTC

2、S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．O％．优于对照组的70．4％(_尸

3、atmentofCommonBileDuctStonesComplicatedwithHepatolithiasis／／DINGXinmin，L1NShuwen，YUANZhiming,WANL~en&JlChenggang(DepartmentofHepatobiliarySurgery,DongguanT~pingPeopleHospital,Dongguan523900,China)【Abstract】ObjectiveTodiscusstheefectofencoscopicretrogradecholangio-pancreatogra(ERCP)andpercutaneoustr

4、anshepaticcholangioscopy(PTCS)inthetreatmentofcholedocholithiasiscomplicatedwithhepatolithiasis．Methods25patientswithcholedocholithiasisandhepatolithiasisweretreatedwithERCP+PTCS(patientsreceivedpercutaneoustranshepaticgastrostomyafterERCPtreatmentofcommonbileductstones，andweretreatwithfistulachole

5、dochofiberscopy5～7daysafterthefirstsurgicaloperation)．Theclinicaldatawerecomparedwith27patientstreatedwithcholedochotomycholedochoscopiclithotomy．ResultsAmong25casesofchOledOchOlithiasisandhepatolithiasistreatedwithERCP+PTCS．thestoneclearanceratewas96．0％．betterthan70．4％ofcontrolgroup(P<0．05)，withsi

6、milarcomplicationrate，shorterlengthofhospitalstayandrelativelyhighcosts>0．05)．ConclusionsThecombinationtherapyofERCPandPTCSisasafeandefectivewaytotreatcholedocholithiasisandhepatolithiasis．【Keywords】Endoscopicretrogradecholangiopancreatography(ERCP)；Percutaneoustranshepaticeholangioscopylithotripsy

7、(PTCS)；cho1edocholithiasis：Hepatolithiasis胆石症是临床上的常见病、多发病，随着十二指肠镜、各治的胆总管结石合并肝胆管结石患者采用ERCP联合PTCS治式胆道镜、腹腔镜的发展和应用，内镜手术已成为治疗胆道疾疗。本组患者共25例，其中男11例，女例14例，年龄33～病的重要手段⋯。内镜下逆行胰胆管造影术(endoscopicretro．86(41．6±8．9)岁。患者均有