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.PDFVIP

中国普外基础与临床杂志 2018 年10 月第25 卷第x 期 • 1 •   ·创新复杂手术荟萃 · 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 1 1 1 1 1 1 2 2 胡继科 ，李雪梅，谷保红，张凡，王博方，冯泽东，魏育才，陈昊 1. 兰州大学第二临床医学院（兰州  730000 ） 2. 兰州大学第二医院肿瘤外科（兰州  730000 ） 【摘要】   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。 【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；  Endoscopic reverse biliary tract stenting placement via choledochus in treatment of situs inversus totalis complicated with choledocholithiasis 1 1 1 1 1 1 2 HU Jike , LI Xuemei , GU Baohong , ZHANG Fan , WANG Bofang , FENG Zedong , WEI Yucai , CHEN Hao2 1. Lanzhou University Second School of Clinical Medicine, Lanzhou 730000, P. R. China 2. Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730000, P. R. China Corresponding author: CHEN Hao, Email: chenhaodrs@163.com 【Abstract 】 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 la