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一种胆囊造瘘术后胆总管结石经皮取石的新技术。

A novel technique of percutaneous stone extraction in choledocholithiasis after cholecystostomy.

作者信息

Lim Kyoung Hoon, Kim Yong Joo

机构信息

Department of Surgery Kyungpook National University hospital, School of Medicine, Kyungpook National University Daegu, Korea.

出版信息

Hepatogastroenterology. 2013 May;60(123):452-5. doi: 10.5754/hge12004.

Abstract

BACKGROUND/AIMS: To evaluate the technical feasibility and clinical efficacy of percutaneous common bile duct stone extraction via cystic duct after percutaneous cholecystostomy.

METHODOLOGY

Twenty-five consecutive patients with choledocholithiasis underwent percutaneous stone extraction under conscious sedation. The stones were extracted through the 12-Fr sheath using Wittich nitinol stone basket under fluoroscopic guidance via cystic duct after percutaneous trnas-hepatic cholecystostomy.

RESULTS

Common bile duct stones were successfully removed in 22 of the 25 patients (88%) by this new technique. The causes of failure in three patients were bile leakage, hematoma of the gallbladder and failure of cystic duct cannulation. Cystic duct injury during this procedure did not occur and there was no post-procedure mortality. The mean period of indwelling catheter was 8.7±4.6 days and the mean duration of hospitalization was 13.4±5.9 days.

CONCLUSIONS

Percutaneous commmon bile duct stone extraction via the cystic duct through percutaneous cholecystostomy route is effective and feasible for treating choledocholithiasis.

摘要

背景/目的:评估经皮胆囊造瘘术后经胆囊管行胆总管结石取出术的技术可行性和临床疗效。

方法

连续25例胆总管结石患者在清醒镇静下接受经皮取石术。在经皮经肝胆囊造瘘术后,于透视引导下,通过12F鞘管,使用维蒂希镍钛合金取石篮经胆囊管取出结石。

结果

采用这种新技术,25例患者中有22例(88%)成功取出胆总管结石。3例失败的原因分别为胆漏、胆囊血肿和胆囊管插管失败。术中未发生胆囊管损伤,术后无死亡病例。导管平均留置时间为8.7±4.6天,平均住院时间为13.4±5.9天。

结论

经皮胆囊造瘘途径经胆囊管行胆总管结石取出术治疗胆总管结石有效且可行。

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