腹腔镜下胆道镜结合iMES-I-B型微电极碎石治疗胆道结石

张伟; 尚培中; 吕瑞昌; 吉玉洁; 南润玲; 李晓武; 苗建军; 张金江; 蔡大伟; 赵伟男; 张洁

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腹腔镜下胆道镜结合iMES-I-B型微电极碎石治疗胆道结石

临床研究 | 更新时间：2023-05-22

- 腹腔镜下胆道镜结合iMES-I-B型微电极碎石治疗胆道结石
- Application of choledochoscopy combined with microelectrode lithotripsy under laparoscopy in treatment of bile duct stones
- 局解手术学杂志 2019年第6期页码：486
- 作者机构：
  
  解放军第251医院普通外科,河北,张家口,075000
- 作者简介：
- 基金信息：
  
  张家口市科学技术研究与发展计划项目（1821115D）
- DOI：
  中图分类号：
- 纸质出版日期：2019，
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张伟, 尚培中, 吕瑞昌, 等. 腹腔镜下胆道镜结合iMES-I-B型微电极碎石治疗胆道结石[J]. 局解手术学杂志, 2019,(6):486.

ZHANG Wei, SHANG Peizhong, LYU Ruichang, et al. Application of choledochoscopy combined with microelectrode lithotripsy under laparoscopy in treatment of bile duct stones[J]. null, 2019,(6):486.
张伟, 尚培中, 吕瑞昌, 等. 腹腔镜下胆道镜结合iMES-I-B型微电极碎石治疗胆道结石[J]. 局解手术学杂志, 2019,(6):486. DOI：

ZHANG Wei, SHANG Peizhong, LYU Ruichang, et al. Application of choledochoscopy combined with microelectrode lithotripsy under laparoscopy in treatment of bile duct stones[J]. null, 2019,(6):486. DOI：

摘要

目的探讨腹腔镜下经纤维胆道镜结合iMES-I-B型微电极碎石仪治疗胆道结石的临床效果及安全性。方法回顾性分析我院2017年7月至2019年3月采用微电极碎石技术治疗取石困难的胆道结石患者50例的临床资料。观察微电极碎石效果以及胆道损伤等并发症，记录取石时间，统计结石取净率。结果 21例患者微电极碎石后通过生理盐水冲洗自行排出，其余29例进一步应用网篮套取结石，从开始碎石到取净结石的时间为20～65 min，平均（41.5±11.2）min，结石取净率为100%（50/50）。术中胆管壁出血3例，术后胆漏2例，术后住院时间为7～14 d，平均（10.2±2.1）d，无患者中转开腹或胆道穿孔。术后4～6周造影无异常拔除T管。结论在腹腔镜下经纤维胆道镜结合iMES-I-B型体内微电极碎石仪治疗取石困难的胆道结石是一种安全、可靠、高效的方法。

Abstract

Objective To investigate the clinical effect and safety of laparoscopy combined with fibrocholedochoscopy and iMES-I-B microelectrode lithotripsy in the treatment of bile duct stones.Methods The clinical data of 50 patients with difficult extrahepatic and intrahepatic bile duct stones underwent microelectrode lithotripsy treated in our hospital from July 2017 to March 2019 were retrospectively analyzed.The effect of microelectrode lithotripsy

biliary tract injury and other complications were observed.The time of stone removal and stone free rate were counted.Results The calculi were washed out by saline in 21 cases and collected by stone basket in 29 cases after microelectrode lithotripsy.The time of stone removal were 20～65 minutes

with the average time of (41.5±11.2)minutes

the stone free rate were 100% (50/50).Intraoperative hemorrhage were in 3 cases

postoperative bile leakage were in 2 cases.The hospitalization time was 7 to 14 days

with the average time of (10.2±2.1)days.None of the cases was converted to laparotomy.No bile duct perforation occurred.The T tube was removed 4~6 weeks after operation.Conclusion iMES-I-B microelectrode lithotripsy treated for difficult bile duct stones via fibrocholedochoscopy is a safe and reliable method

which obviously raises the stone free rate of bile duct stones.

关键词

胆道结石胆道外科手术腹腔镜检查胆道镜检查微电极碎石

Keywords

choledocholithiasisbiliary tract surgical procedureslaparoscopycholedochoscopymicroelectrode lithotripsy

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