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find Keyword "经皮经肝胆道镜碎石取石术" 2 results
  • Value of percutaneous transhepatic choledochoscopic lithotripsy in treatment of recurrent type Ⅱa hepatolithiasis

    ObjectiveTo investigate the feasibility and safety of percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) in the treatment of recurrent type Ⅱa hepatolithiasis.MethodsAll of 293 patients with recurrent type Ⅱa hepatolithiasis admitted to the Second Affiliated Hospital of Chongqing Medical University from December 2010 to December 2017 were collected retrospectively, 82 of whom were treated with the PTCSL (PTCSL group), 211 of whom were treated with traditional open surgery (open group). The patients were matched according to the ratio of 1∶1 by using the method of propensity score matching, then the patients were compared after matching.ResultsA total of 59 pairs were successfully matched, that was, there were 59 patients in the PTCSL group and open group, respectively. Compared with the open group, the PTCSL group had the similar conditions such as the gender, age, preoperative Child-Pugh classification, and times of previous biliary operations, etc. (P>0.050). There was no perioperative death in both groups. There were no significant differences between the two groups in the success rate, operation time, times of operations, time of T tube removal after operation, stone residual rate, and stone recurrence rate (P>0.050). Although the hospital costs of the PTCSL group was higher than that of the open group (P<0.050), the PTCSL group had various advantages, such as less intraoperative bleeding, smaller incisional scar, shorter hospital stay and postoperative ventilation time, and lower rate of total postoperative complications (P<0.050).ConclusionsAfter learning curve, PTCSL has many advantages over traditional open surgery in treatment of recurrent type Ⅱa hepatolithiasis. PTCSL is a minimally invasive surgery, which is safe and effective.

    Release date:2020-12-25 06:09 Export PDF Favorites Scan
  • 经皮经肝胆道镜碎石取石术治疗胆肠吻合术后肝胆管结石病

    目的探讨经皮经肝胆道镜碎石取石术(PTCSL)必要时联合球囊扩张治疗胆肠吻合术后肝胆管结石病的可行性及安全性。方法重庆医科大学附属第二医院 2015 年 12 月至 2020 年 12 月期间共有 54 例胆肠吻合术后肝胆管结石病患者接受 PTCSL 必要时联合球囊扩张治疗(符合纳入标准)。回顾性收集患者的一般资料、手术情况、术后情况以及术后随访资料。结果54 例患者中有 52 例(96.3%)行 PTCSL 治疗成功,2 例因为胆肠吻合口完全闭塞而失败。术中出血量的中位数为 55 mL(15~520 mL);取净结石 48 例(88.9%),结石残留 6 例(11.1%)。术后并发症发生率为 27.8%(15/54),无围手术期死亡患者。取净结石的 48 例患者获随访,中位随访时间 33 个月(2~60 个月),有 10 例结石复发,复发率为 20.8%(10/48)。结论PTCSL 必要时联合球囊扩张治疗胆肠吻合术后肝胆管结石病具有良好的安全性和可行性,但是术后需要注意预防结石复发。

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