Hwang M H, Tsai C C, Mo L R, Yang C T, Yeh Y H, Yau M P, Yueh S K
Department of Surgery, Show Chwan Memorial Hospital, Chang Hwa, Taiwan, ROC.
Eur J Radiol. 1993 Nov;17(3):184-90. doi: 10.1016/0720-048x(93)90101-r.
Our experience in non-operative retrieval of biliary tract stones through PTCS (percutaneous transhepatic cholangioscopy, n = 103) and POC (post-operative choledochoscopy, n = 542) plus the use of Dormia basket and EHL (electrohydraulic lithotripsy) is presented. The results of transhepatic and T-tube routes are compared, with emphasis on the technical difficulties encountered. The success rates were 96% and 97% in POC and PTCS, respectively. No mortality was related to these procedures. Intrahepatic duct angulation and stricture were the factors most often responsible for failure. Postoperative choledochoscopic stone removal is safe and the method of choice for retained biliary tract calculi, while PTCS is highly indicated for those high-risk patients with or without previous biliary surgery. POC and PTCS have, therefore, their own indications and differ in their clinical applications.
本文介绍了我们通过经皮经肝胆道镜检查（PTCS，n = 103）和术后胆道镜检查（POC，n = 542）非手术取出胆道结石的经验，以及使用多尔米亚网篮和电液压碎石术（EHL）的情况。比较了经肝途径和T管途径的结果，重点关注遇到的技术难题。POC和PTCS的成功率分别为96%和97%。这些操作未导致死亡。肝内胆管成角和狭窄是最常导致失败的因素。术后胆道镜取石安全，是残留胆道结石的首选方法，而PTCS对于有或无既往胆道手术史的高危患者非常适用。因此，POC和PTCS有各自的适应症，临床应用也有所不同。
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