胆道镜配合取石网篮在胆总管探查取石术中的临床应用分析

目的：探讨胆道镜配合取石网篮在胆总管探查取石术中的临床效果。方法：选取我院于2007年1月至2011年12月收治的行胆道镜配合取石网篮胆总管探查取石手术患者460例，对其临床资料进行分析。结果：本组460例均顺利完成手术，手术时间30—120min，平均80±12min，术中出血量60-100mL，平均86±14mL，所有患者术后均放置T管引流。术后无出血、严重感染及胆漏等并发症，住院时间10-14d，平均12±2．2d，T管引流量每天300—1100mL，平均750±101．3mL。术后2周行T管造影，术后3周行胆道镜检查，122例结石残留，带管出院，术后6周再行胆道镜配合取石网篮取胆总管残余结石。术后随访6—12个月，行肝功能、B超或CT检查，无黄疸，未见胆管残留结石和胆管狭窄。结论-开腹胆总管探查术胆道镜配合取石网篮取石具有操作较为简单，手术并发症少，住院时间短，医疗费用低等优点，本研究为胆道镜配合取石网篮胆总管探查取石术在基层医院应用提供了临床依据。

Clinical Application-Analysis on Choledochoscopy Coordination Stone Basket in the Common Bile Duct Exploration

Objective： To explore clinical effect choledochoscopy coordination stone basket in the com- mon bile duct exploration . Method：460 eases treated in our hospital from January 2007 to December 2011 on choledochoscopy coordination stone basket in the common bile duct exploration were chosen , the clinical data were analyzed. Result： All 460 cases have been favorably operated , operation time was 30-120 mi- nutes, the average was 80 - 12 min, the bleeding volume in operation was 60-100mL, the average was 86 -14mL,all patients were placed T tube drainage after operation. There was no postoperative bleeding, severe infections and complications such as biliary fistula. Length of time was 10-14 days, the average was 12-2.2 days, the pipe flow every day was 300-1100 mL with T tube, the average was 750±101.3mL. After 2 weeks They were given T cholangiography, and after 3 weeks were given biliary tract endoscopy i among them 122 cases were with residual stones, and discharged with tube. After 6 weeks they were given an operation on choledochoscopy coordination stone basket for bile duct residual stones. After follow-up for 6-12 months. they were given liver function, B ultrasound and CT examination, and without jaundice, no residual stone in bile duct and bile duct stricture. Conclusion：The operation of laparoseopic common bile duct exploration choledochoscopy coordination stone basket stone has the advantage of simple operation, less complications~ shorter hospital stay, and a low medical cost , The research provides clinical evidence for choledochoscopy co- ordination stone basket in the common bile duct exploration in the application of basic level hospital .