术后胆管难取性残留结石的治疗

目的：探讨术后肝内外胆管难取性残留结石安全有效的治疗方法。方法：采用碎石、表麻胆管松动结石、水压冲击和结石表面注入H202后经胆道镜取石的方法治疗136例胆道难取性残留结石。结果：136例中，用活检钳碎石83例；用1％利多卡因注入含残石胆管、胆管壁松驰，结石松动套入取石网篮碎石18例；用生理盐水加压冲击胆管使结石松动，再用网蓝碎石19例；注入H202至残石表面，使之腐蚀碎石16例。结论：活检钳碎石，表麻后松驰胆管壁，生理盐水加压冲洗胆管和注入H202至残石表面腐蚀变小，再套入取石网蓝勒夹碎石，是治疗肝内外胆管术后残留难取性结石的较为简便、有效、安全的方法。

Experience with intractably residual cholelithes

Objective:To summarize the effect of fiber choledochoscope on the treatment of intractably residual cholelithes.Methods:A total of 136 patients with intractably residual cholelithes had been treated with fiber choledochoscope.After biopsy forceps lithotripsy,loosing stones,water flushing and injecting H 2O 2 into the stone surface,the stones were removed by the use of the basket.Results:The rates of stone removal by way of biopsy forceps lithotripsy,loosing stones,water flushing and injecting H 2O 2 into the stone surface were 90.4%(75/83),94.4%(17/18),89.5%(17/19) and 93.8%(15/16),respectively.Conclusion:Fiber choledochoscope is a simple,effective and safe method for treating intractably residual bile duct stones.