Wang B S, Yao L Q, Wang C X
Zhongshan Hospital, Shanghai Medical University.
Zhonghua Wai Ke Za Zhi. 1994 Feb;32(2):100-2.
Basket lithotriptor, piezoelectric shock wave lithotripsy, electrohydraulic shock wave lithotripsy, and endoscopic papillosphincterotomy were used to manage respectively 10, 15, 14, and 15 patients with retained intra and extrahepatic bile duct stones that could not be removed with a Dormia basket. In these four group patients the stones ranged from 5 to 25 mm in diameter. A residual stone was fragmented with a basket lithotriptor if its diameter exceeded that of the T tube tract. Shock-wave was used when mechanical lithotripsy was unsuccessful. Endoscopic papillosphincterotomy was carried out in patients with stenosis of the sphincter, or impacted stone at the Ampulla of Vater. Combined biliary lavage, Dormia basket, and choledochoscopy after lithotripsy accelerated clearance of fragments. In these four groups, stone-free rates and reoperation rates were 90, 46.7, 85.7, and 100 percent and 10, 6.6, 14.3, and 0 percent respectively. There were no serious complications.
采用网篮碎石器、压电冲击波碎石术、液电冲击波碎石术及内镜下乳头括约肌切开术分别治疗10例、15例、14例和15例不能用多尔米亚网篮取出的肝内外胆管残留结石患者。这四组患者结石直径为5至25毫米。如果残留结石直径超过T管窦道直径，则用网篮碎石器将其击碎。机械碎石术不成功时则使用冲击波。对括约肌狭窄或结石嵌顿于十二指肠乳头的患者实施内镜下乳头括约肌切开术。碎石术后联合胆道灌洗、多尔米亚网篮及胆道镜检查可加速碎片清除。这四组患者的结石清除率分别为90%、46.7%、85.7%和100%，再次手术率分别为10%、6.6%、14.3%和0%。无严重并发症发生。
