论文部分内容阅读
目的：进一步提高胆道镜结石取净率，从而提高胆管结石治愈率。方法：对９年来所作的７４７例胆道镜检查取石情况（围绕残石原因、术前影像学检查价值和几种困难残石病例的取石技术）作一分析探讨。结果：７４７例中有残石６３６例，共行镜检取石８３４例次，取净率达９７．１７％；Ｔ管造影残石假阴性率为１１．７％（７／６０）；Ｂ超检查的假阴性率为６．６７％（２／３０）。结论：强调术中取石应以最大限度地降低术后镜检取石难度为宗旨；对于胆道镜的适应证选择不能单纯依赖Ｔ形管造影或Ｂ超检查，术者的意见亦应充分考虑；对于困难结石的取除提出综合治疗的措施，镜检应细心、耐心、全面。
Objective: To further improve the cholecystolithiasis rate, so as to improve the cure rate of bile duct stones. Methods: A total of 747 cases of cholecystolithiasis during 9 years (including the cause of residual stones, the value of preoperative imaging examination and stone removal techniques of several difficult residual stone cases) were analyzed. Results: Of the 747 cases, 636 were found with residual stone, 834 cases were taken by microscopy, and the net acquisition rate was 97.17%. The false negative rate of T-tube was 11.7% (7/60) The false negative rate was 6.67% (2/30). Conclusion: Emphasizing intraoperative lithotomy should be to minimize the difficulty of postoperative microscopic examination of stone for the purpose of cholecystectomy indications can not be relied on T-tube angiography or B-ultrasound alone, the views of the surgeon should also be fully considered; for Removal of difficult stones to put forward the comprehensive treatment measures, microscopic examination should be careful, patient and comprehensive.