查詢結果分析
來源資料
相關文獻
- 經皮穿肝膽道鏡治療肝內結石之長期成績
- Management of Biliary Calculus Diseases
- Histomorphometric Evaluation of Mucin Content in Stone-Containing Intrahepatic Bile Ducts
- Pathology of Hepatolithiasis
- 再論肝內結石與肝管癌
- 經皮穿肝膽道鏡取石術--病例報告
- 肝葉切除術以治療左肝內結石症
- 經皮穿肝膽道鏡術
- Choledochoscopic Heat-Probe Therapy: An Adjunctive Palliative Treatment for Intrahepatic Cholangiocarcinoma With Hepatolithiasis
- 照顧一位肝內結石的護理經驗
頁籤選單縮合
題 名 | 經皮穿肝膽道鏡治療肝內結石之長期成績 |
---|---|
作 者 | 詹益銀; 陳敏夫; | 書刊名 | 長庚醫學 |
卷 期 | 17:2 1994.06[民83.06] |
頁 次 | 頁149-152 |
分類號 | 416.246 |
關鍵詞 | 經皮穿肝膽道鏡; 肝內結石; Percutaneous transhepatic cholangioscopy; PTCS; Hepatolithiasis bile duct stricture; Retained stones; Recurrent stones; |
語 文 | 中文(Chinese) |
中文摘要 | 長庚紀念醫院一般外科自1983年10月至1987年9月共使用經皮穿肝膽道鏡術(Percutaneous Transhepation cholangioscopy, PTCS)治療肝內結石38例,男20例,女18例;年齡?對18歲曘大85歲平均44歲。肝內結石的位置:在側肝管13例,右側14例,兩側11例。35位病人以前有膽道手術之病史。33位病人有一般或多處膽管狹窄。PTCS取石成功?32例經追蹤3至7年之長期成績:情況良好無結石再發者16例占50%,有肝內結石再發者14例占43.8%,2位病人無結石再發但因膽管狹窄引發膽管炎症狀。14位病人有腹痛或膽管炎症發作入院,其中8例接受剖腹或經皮穿肝引流治療。肝內結石合併膽管狹窄33例經PTCS治療後6例仍有殘石占18.2%而無膽管狹窄者5例治療成功。PTCS取石成功32例其中合併膽管狹窄者27例經長期追蹤有結石兩發者14例占52%,無膽管狹窄者5例均無結石再發。有1例殘石及1例再發肝內結石於術後追蹤期間發生膽管癌不治死亡。 |
英文摘要 | Thirty-eight cases of hepatolithiasis were treated by percutaneous transhepatic cholangiscopay (PTCS) from Oct. 1983 to Sept. 1987 at the Chang Gung Memorial Hospital. Three were 20 males and 18 females, age distribution ranged from 18 to 85, with a mean of 44 year old. Those with a history of previous biliary operation for biliary calculi were the majority, representing 92.1% (35 cases) of patients. The location of the stones in 38 cases were: bilateral IHD in 11, right IHD in 14, left IHD in 13. Hepatolithiasis associated with intrahepatic duct or biliary-enteric anastomotic stricture occurred in 84.2% (32 cases). Those strictures were dilated byi PTCS drainage catheter in 7 cases. Complete removal of hepatolithiasis by PTCS in 32 cases resulted in a success rate of 84.2%. The sessions of PTCS ranged from 1 to 18, or a mean of 5. Two cases had major complications during the course of PTBD and required a change to a PTCS catheter; one case had subphrenic hematoma which needed laparotomy, and another case had hemobilia with sepsis which resulted, in mortality. Long-term follow-up results in 32 cases of successful PTCS in hepatolithiasis with a range from 3 to 7 years period were free of symptoms and without evidence of recurrent stones in 50% (16/32), free of symptoms with recurrent stones in 2 cases. Recurrent stones with cholangitis occurred in 10 cases and 2 cases had symptoms of cholangitis without evidence of recurrent stones. Post-ptcs retained stones rate in hepatolithiasis with versus without bile duct stricture are: 6/33 (18.2%), 0/5 (0%), respectively. Post-PTCS recurrent stones rate in hepatolithiasis with versus without bile duct stricture are: 14/27 (52%), 0/5 ()0% respectively. Two out of 38 patients (5.2%) developed cholangocarcinoma during the follow up period. PTCS is an effective and safe procedure for non-surgical management of intrahep c stones. Post-PTCS retained and recurrent stones rates in hepatolithiasis were still high in the long term follow-up, 15.8% and 43.7%, respectively. Overall mortality in the long-term follow up study was 7.9%, with cholangiocarcinoma the main causes of death. |
本系統中英文摘要資訊取自各篇刊載內容。