摘要
目的探讨医源性胆管损伤后肝外胆管再狭窄的原因和治疗方法。方法对我院1998年1月～2005年1月12例（开腹胆囊切除术5例，腹腔镜胆囊切除术7例）医源性胆管损伤后肝外胆管再狭窄，建立经皮经肝通道，采用胆道镜取石、球囊扩张、支架管置入支撑扩张狭窄段胆管。结果8例用F20 Gruntzig型球囊导管扩张狭窄段胆管，2次即可放入6～8mm塑料支架引流管；4例球囊扩张3次后置入。塑料支架引流管置管6～12个月。12例随访2～3年，平均2．6年，无腹痛、发热、黄疸再次发作，B超、MRCP检查胆管无狭窄及再发结石。结论胆道镜取石、球囊扩张支架管置入治疗医源性胆管损伤后肝外胆管再狭窄创伤小，安全可行，效果良好。
Objective To discuss the etiology and treatment of extrahepatic biliary stenosis due to iatrogenic bile duct injuries. Methods A total of 12 cases of extrahepatic biliary stenosis after iatregenic bile duct injuries （ including 5 cases of open cholecystectomy and 7 cases of laparoscopic cholecystectomy） from January 1998 to January 2005 in this hospital was reviewed. After the establishment of a pereutaneous transhepatic access, choledochoscopic stone removal, balloon dilatation, and drainage stent placement were performed for treating biliary stenosis. Results A F20 Gruntzig balloon catheter was employed for bile duct dilatation. The plastic drainage stent at 6 - 8 mm in diameter was successfully placed after 2 times of dilatation in 8 cases and after 3 times of dilatation in 4 cases, for 6 -12 months of indwelling. Follow-up observations in the 12 cases for 2 -3 years （mean, 2.6 years） found no abdominal pain, fever, or jaundice. B-uhrasonography and MRCP findings showed no biliary stenosis and recurrent stones. Conclusions Choledochoscopic stone removal, balloon dilatation, and drainage stent placement are minimally invasive, safe, and effective in the treatment of extrahepatic biliary stenosis.
出处
《中国微创外科杂志》
CSCD
2006年第11期879-880,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
胆囊切除术
胆管损伤
胆管狭窄
胆道镜
球囊扩张
支架
Cholecystectomy
Bile duct injury
Biliary stenosis
Cholangioscopy
Balloon dilatation
Stent
