经T管输尿管软镜治疗胆总管残余结石1例报告

陈时红; 吴栋; 文洪; 陈元军; 曹刚

doi:10.3969/j.issn.1001-5256.2023.09.022

经T管输尿管软镜治疗胆总管残余结石1例报告

DOI: 10.3969/j.issn.1001-5256.2023.09.022

陈时红¹,
吴栋²,
文洪¹,
陈元军³,
曹刚^1, , ,

1.
贵州省第二人民医院普通外科，贵阳 550000
2.
山东大学齐鲁医院胰腺外科，济南 250000
3.
贵州省黔南州惠水县人民医院肝胆普外科，贵州黔南布依族苗族自治州 550600

基金项目:

国家自然科学基金 (81900731)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：陈时红、吴栋负责课题设计，资料分析；陈时红、文洪负责撰写论文；陈时红、曹刚参与收集数据，修改论文；曹刚、吴栋、陈元军负责拟定写作思路，指导撰写并最后定稿。

详细信息

通信作者:
曹刚， 13984862480@163.com （ORCID： 0000－0002－8631－3336）

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出版历程
- 收稿日期: 2022-11-08
- 录用日期: 2022-12-26
- 出版日期: 2023-09-19

T－tube flexible ureteroscopy in treatment of residual choledocholithiasis： A case report

1.
Department of General Surgery，The Second People’s Hospital of Guizhou Province，Guiyang 550000，China
2.
Department of Pancreatic Surgery，Qilu Hospital of Shandong University，Jinan 250000，China
3.
Department of Hepatobiliary Surgery，Huishui County People’s Hospital，Qiannan Buyi and Miao Autonomous Prefecture，Guizhou 550600，China

Research funding:

National Natural Science Foundation of China (81900731)

More Information

Corresponding author: CAO Gang， 13984862480@163.com （ORCID： 0000－0002－8631－3336）

摘要

摘要: 目前，对于术后胆总管残余结石的治疗，内镜逆行胰胆管造影（ERCP）和经T管窦道取石是主要的治疗手段，但以上治疗方法都存在一定的弊端，例如ERCP可能引起术后胰腺炎、出血、穿孔等并发症，T管窦道取石可能引起窦道损伤、窦道出血等。而输尿管软镜作为泌尿外科常用器械之一，具有直径小、角度灵活等特点，对于治疗胆总管结石具有良好的前景。贵州省第二人民医院普通外科应用输尿管软镜联合取石篮成功治疗胆总管结石1例，至今已随访7个月，患者无特殊不适，复查磁共振胰胆管成像检查未见胆总管结石。
- 胆总管结石病 /
- 输尿管镜 /
- 胰胆管造影术，磁共振
Abstract: At present， endoscopic retrograde cholangiopancreatography （ERCP） and T－tube sinus tract lithotomy are the main treatment methods for residual choledocholithiasis after surgery. However， these treatment methods have certain drawbacks； for example， ERCP may cause complications such as postoperative pancreatitis， bleeding， and perforation， and T－tube sinus tract lithotomy may cause sinus tract injury and bleeding. As a commonly used instrument in urology， flexible ureteroscope has the characteristics of small diameter and flexible angle and thus has a good prospect in the treatment of common bile duct stones. A patient with common bile duct stones was successfully treated by flexible ureteroscopy combined with a stone basket in Department of General Surgery， The Second People’s Hospital of Guizhou Province. Up to now， the patient has been followed up for seven months with no special discomfort， and magnetic resonance cholangiopancreatography showed no common bile duct stones.
- Choledocholithiasis /
- Ureteroscopes /
- Cholangiopancreatography， Magnetic Resonance

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图 1 影像学资料

注： a，术前MRCP；b，术前T管造影，箭头处为结石；c，术后MRCP；d，术后随访7个月MRCP，均无结石残留。

Figure 1. Radiological images

下载: 全尺寸图片幻灯片

表 1 患者外院血清指标水平变化比较

Table 1. Comparison of the changes of serum indexes of patients in other hospital

指标	术前	术后1 d	术后3 d	术后5 d	术后7 d
WBC（×10⁹/L）	14.95	10.21	5.80	5.43	4.96
NEC#（×10⁹/L）	12.17	8.97	3.74	3.37	2.97
CRP（mg/L）	0.28	58.79	42.21	14.39	2.82
ALT（U/L）	26.4	32.6	20.7	33.2	75.5
AST（U/L）	36.3	39.3	20.0	39.7	59.3
TBil（μmol/L）	24.0	19.6	14.7	20.9	18.5
DBil（μmol/L）	13.00	11.33	7.39	11.01	10.64
IBil（μmol/L）	11.00	8.27	7.31	9.89	7.86
注：NEC#，中性粒细胞绝对值； CRP，C反应蛋白。

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