一项为期10年的单中心经验：在T管原位情况下经皮和内镜下取胆管结石。
A 10 year single centre experience of percutaneous and endoscopic extraction of bile duct stones with T tube in situ.
作者信息
Nussinson E, Cairns S R, Vaira D, Dowsett J F, Mason R R
机构信息
Department of Gastroenterology, Middlesex Hospital, London.
出版信息
Gut. 1991 Sep;32(9):1040-3. doi: 10.1136/gut.32.9.1040.
A non-randomised single centre study of 226 consecutive patients referred over 10 years with retained common bile duct stones and a T tube in situ or a cholecystostomy tube are reported. Percutaneous extraction was attempted in 204 and endoscopic extraction in 68 patients. Percutaneous clearance was achieved in 158 (77.5%) patients and endoscopic clearance in 52 (76.5%) patients. Six of 153 (3.9%) patients followed after percutaneous treatment suffered major complications (pancreatitis, cholangitis, or tract perforation). Three of 67 (44%) patients followed after endoscopic treatment suffered major complications (pancreatitis, cholangitis, or bleeding). When the initial method of treatment failed, the alternative was used, resulting in an overall success rate of bile duct clearance of 94.3%. It is concluded that percutaneous and endoscopic methods of bile duct clearance in patients with a T tube in situ are equally effective, carrying similar complication rates. This study has helped to clarify the indications and efficacy of these alternative treatments.
报道了一项非随机单中心研究，该研究纳入了连续10年转诊来的226例胆总管结石残留且留置T管或胆囊造瘘管的患者。204例患者尝试了经皮取石，68例患者尝试了内镜取石。158例（77.5%）患者经皮取石成功，52例（76.5%）患者内镜取石成功。经皮治疗后随访的153例患者中有6例（3.9%）发生了严重并发症（胰腺炎、胆管炎或穿刺道穿孔）。内镜治疗后随访的67例患者中有3例（4.4%）发生了严重并发症（胰腺炎、胆管炎或出血）。当初始治疗方法失败时，采用另一种方法，胆管清除的总体成功率为94.3%。得出结论，对于留置T管的患者，经皮和内镜胆管清除方法同样有效，并发症发生率相似。本研究有助于明确这些替代治疗的适应证和疗效。
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