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題名 | 經由胆道鏡使用雷射碎石術治療殘餘胆道結石之經驗: 三例報告 |
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作者姓名(中文) | 詹益銀; 陳敏夫; 方昆敏; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 18:2 1985.06[民74.06] |
頁次 | 頁218-222 |
分類號 | 416.247 |
關鍵詞 | 胆道鏡; 雷射碎石術; 殘餘胆道結石; |
語文 | 中文(Chinese) |
中文摘要 | 總胆管或肝內肝管的手術後殘留結石,近年來因使用術後胆道纖維鏡取石治療,使結石殘留率大大地降低。但對于巨大型或箝住性結石,但胆道纖維鏡取石治療常有困難;而病人往往需要接受再次手術之治療。 本報告3例因急性化膿性胆管炎接受緊急手術;施行總胆管切開取石治療及T形管引流術。術後經T形管胆道攝影發現2例在左側肝管有箝住性結石,另1例巨大結石箝住總胆管末端;雖經術後胆道鏡取石治療但無法奏效。因此,我們經由胆道鏡使用Nd-YAG laser直接把結石弄碎後再使用網狀鉗子(basket forcep)將碎石取出,成功地治療3例胆道殘留結石。 |
英文摘要 | Retention of biliary stones is the most common troublesome situation in the field of biliary surgery. Post-operative choledochofibroscopy is a useful and effective method for treatment of retained stones, but incarcerated large retained stones, stones located at the peripheral duct or associated, with biliary strictures are still main challenges in post-operative choledochofibroscopy. Incarcerated stones can be crushed by 3-arm, w-shaped or penetrating forceps. YAG laser beam can be used for framentation of giant and/or incarcerated stones through T-tube or PTBD fistula. Quartz fiber carrying a laser beam (0.6 mm in diameter) can pass into a small hepatic or stricture duct through a small basket channel such as CHF-4B. Incarcerated left IHD stones (Cases 1 and 2) and retained giant distal CBD stone (Case 3) are destroyed successfully by YAG laser with a choledochofibroscope through T-tube fistula. Lithotomy by YAG laser with choledochoscopy is effective and safe if the laser catheter can be directly attack the stones. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。