【Abstract】Objective To observe the bacteria in cholesterol stones by electronic microscope and to explore the role of bacteria in the stone formation.Methods Twelve patients with cholelithiasis underwent operations (male 6, female 6, average age 54.6 years） with cholecystolithiasis 5, extrahepatic and intrahepatic bile duct stone 1, common bile duct stone combining with gallstone 6. The cholesterol stones were observed by electronic microscope.Results There were bacterial structures in the cholesterol stones and cholesterol crystals.Conclusion There are bacteria in the core and peripheral of cholesterol stones, which suggests that bacteria may play an initial role in the formation of cholesterol stones.
目的 探讨金属银夹标记胆道通道，利用胆道镜技术治疗胆肠吻合术后肝胆管结石复发的可行性、安全性和有效性。方法 回顾性分析大连市友谊医院47例胆管结石行胆肠Roux-en-Y吻合术患者的资料，在空肠盲袢或输出袢处使用银夹作标志，术后通过胆道镜行胆管残留结石或复发结石或狭窄的治疗。结果 11例术后胆管残留结石和5例残留结石合并胆管狭窄者经T管窦道行胆道镜探查、取石及肝胆管狭窄的治疗而治愈。2例结石复发的患者根据空肠的金属银夹标记物，在数字减影血管造影（DSA）下进行穿刺置管建立胆道镜通道，通过胆道镜成功取出了结石，避免了再手术。结论 发挥胆道镜技术治疗肝胆管结石的优势，经以银夹标志的胆道通道，可望成为治疗胆肠吻合术后复发结石手段的有益补充。
【摘要】目的 探讨纤维胆道镜对肝胆管狭窄的诊治价值。 方法 对45例肝胆管狭窄患者进行纤维胆道镜诊治，总结分析其方法的优越性。根据不同狭窄类型，治疗采取活检钳撕破狭窄膜或镜身扩张法、球囊扩张加支架支撑法。 结果 所有病例均成功治愈，无一例出现明显并发症。 结论 纤维胆道镜治疗胆管狭窄具有微创、安全、有效及方便等优点，是治疗肝胆管狭窄的有效手段。
【Abstract】Objective To discuss the application of endoscopic diagnosis and treatment of biliary stone with choledochofiberscope after orthotopic liver transplantation.Methods Five patients with repeated infection of bile duct and obstructive jaundice were treated with choledochofiberscope through T tube sinus, combining with the plasma shock wave lithotripsy, the eyewinker clam and the basket extraction. Results We could efficiently extract the biliary tract stone through choledochofiberscope combining with plasma shock wave lithotripsy, eyewinker clam and basket extraction; and observe the healing appearance, and blood circulation of the biliary tract. Conclusion The choledochofiberscope can be used to diagnose and treat biliary tract stone of orthotopic liver transplantation. The choledochofiberscope and T tube will be important in diagnosis and treatment of biliary tract stone following orthotopic liver transplantation.