中国普外基础与临床杂志

中国普外基础与临床杂志

内镜下经胆总管逆向胆管支架置入术治疗全内脏反位并胆管结石

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目的 总结内镜治疗全内脏反位并胆管结石的经验。 方法 回顾性分析兰州大学第二医院肿瘤外科收治的 1 例全内脏反位并胆管结石患者的临床资料。 结果 首次入院后尝试行 ERCP 失败继而行胆囊切除+胆总管切开取石+T 管引流术将结石清除,2 个月后结石复发,二次入院后行钬激光碎石+经胆总管逆向胆管支架置入术,术后恢复良好,现已术后 2 个月余,无结石复发,患者恢复良好。 结论 经胆总管逆向胆管支架置入术是一项可行的技术操作,今后可作为对全内脏反位并胆管结石患者的一种治疗方式选择。

Objective To summarize experience of endoscopic reverse biliary tract stent placement via choledochus in treatment of situs inversus totalis complicated with choledocholithiasis. Methods The clinical data of one patient with total visceral inversion complicated with bile duct stones in the Department of Tumor Surgery of Lanzhou University Second Hospital were retrospectively analyzed. Results The ERCP was failed at the first admission, followed by the cholecystectomy plus choledocholithotomy plus T-tube drainage, the stones were removed. Two months later, the stones recurred, then the holmium laser lithotripsy and bile duct stenting placement was performed at the secondary admission, the postoperative recovery was good, it had been more than 2 months after the surgery, no stone recurrence occurred. Conclusion Endoscopic reverse biliary tract stenting placement via choledochus is feasible, which can be used as an option for treatment of patient with situs inversus totalis complicated with choledocholithiasis.

关键词: 内脏转位; 胆管结石; 胆道镜; 激光碎石术; 内镜逆行胰胆管造影;  

Key words: situs inversus; cholangiolithiasis; choledocholithotomy; cholangioscopy; laser lithotripsy; endoscopic retrograde cholangiopancreatography

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