[1]张 强,尹春辉,李晓光,等.经皮经肝穿刺Fogarty球囊推石治疗胆总管结石[J].介入放射学杂志,2020,29(10):995-999.
 ZHANG Qiang,YIN Chunhui,LI Xiaoguang,et al.Percutaneous transhepatic papilla balloon dilatation combined with Fogarty balloon pushing technique for the treatment of common bile duct stones[J].journal interventional radiology,2020,29(10):995-999.
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经皮经肝穿刺Fogarty球囊推石治疗胆总管结石()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
29
期数:
2020年10
页码:
995-999
栏目:
非血管介入
出版日期:
2020-10-25

文章信息/Info

Title:
Percutaneous transhepatic papilla balloon dilatation combined with Fogarty balloon pushing technique for the treatment of common bile duct stones
作者:
张 强 尹春辉 李晓光 游国超 徐化静 集 冰 张雪梅
Author(s):
ZHANG Qiang YIN Chunhui LI Xiaoguang YOU Guochao XU Huajing JI bing ZHANG Xuemei.
Department of Interventional Radiology, Anyang District Hospital, Anyang, Henan Province 455000, China
关键词:
【关键词】 胆总管结石 经皮乳头球囊扩张术 经皮经肝穿刺胆道引流术 介入治疗
文献标志码:
A
摘要:
【摘要】 目的 探讨经皮经肝穿刺入路,十二指肠乳头球囊扩张联合Fogarty球囊推送治疗胆总管结石的安全性及有效性。 方法 回顾性分析14例胆管结石患者。常规经皮经肝穿刺胆管,置入8 F血管鞘,超滑加硬导丝置入十二指肠内,应用半顺应性球囊扩张十二指肠乳头,扩张2次,每次持续1~2 min;后撤出球囊,应用Fogarty球囊缓慢经结石上方沿导丝,向肠道内推送结石。若结石较大,更换大于原扩张球囊直径2 mm的球囊再次扩张乳头,并再次尝试推送结石,球囊最大直径不超过18 mm。若仍取出困难,停止手术。术后置入8 F外引流管于胆总管内,持续外引流。术后常规禁食、抗炎等治疗。1个月以后复查CT及超声,若无结石残留,拔出引流管,其后1、3和6个月复查彩超。结果 13例成功取出,成功率92.6%(13/14),其中1例因结石较大,最大径大于25 mm,未能成功取出。术后1周无感染加重,发热、黄疸、腹痛等症状逐渐消失。合并急性胰腺炎及胆囊炎患者均保守治疗治愈。肝被膜下出血1例,胆道少量出血1例,保守治疗好转。随访期内无结石复发。结论 经皮经肝穿刺十二指肠乳头球囊扩张球囊推迭治疗胆总管结石,技术可行,安全有效,局麻下即可实施,是胆管结石的有效微创治疗方法,特别适合于高龄、基础疾病多、心肺功能差、不能耐受全麻,或者毕Ⅱ(Billroth Ⅱ)式术后内镜无合适路径的胆总管结石患者。

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备注/Memo

备注/Memo:
(收稿日期:2020- 01- 15)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2020-10-19