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中华肝脏外科手术学电子杂志 ›› 2023, Vol. 12 ›› Issue (06) : 591 -596. doi: 10.3877/cma.j.issn.2095-3232.2023.06.001

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肝内胆管结石微创治疗策略
邱朋, 邓正栋, 王剑明()   
  1. 430030 武汉,华中科技大学同济医学院附属同济医院胆胰外科
    430030 武汉,华中科技大学同济医学院附属同济医院小儿外科
    430030 武汉,华中科技大学同济医学院附属同济医院胆胰外科;430064 武汉科技大学附属天佑医院肝胆外科
  • 收稿日期:2023-07-20 出版日期:2023-12-10
  • 通信作者: 王剑明
  • 基金资助:
    国家自然科学基金(81874062,82072730)

Minimally invasive treatment strategies for intrahepatic bile duct stones

Peng Qiu, Zhengdong Deng, Jianming Wang()   

  • Received:2023-07-20 Published:2023-12-10
  • Corresponding author: Jianming Wang
引用本文:

邱朋, 邓正栋, 王剑明. 肝内胆管结石微创治疗策略[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 591-596.

Peng Qiu, Zhengdong Deng, Jianming Wang. Minimally invasive treatment strategies for intrahepatic bile duct stones[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 591-596.

肝内胆管结石是指位于左右肝管汇合部以上各分支胆管内的结石,好发于亚洲人群[1]。肝内胆管结石患者结石分布一般较广泛且伴随着胆道狭窄,这也是该疾病术后结石残留率和复发率高的重要原因。目前腹腔镜、机器人手术系统、胆道镜及十二指肠镜等众多微创技术已取得一系列进展和突破,加之微创和快速康复等观念的提出及手术操作者的经验累积,肝内胆管结石的治疗已逐渐微创化,显著减少了患者手术创伤,降低了术后结石残留率和复发率,提高了该疾病的治疗水平[2]。由于各种微创技术自身的局限性和适应证的把握不准,目前肝内胆管结石的治疗还未达到预期效果。本文旨在总结治疗肝内胆管结石的微创方式,分析各微创治疗手段的最佳受益人群,进一步探讨提高肝内胆管结石疗效的个体化策略。

图1 肝内胆管结石微创术式注:PTCSL为经皮经肝胆道镜取石术,PTOBF为经皮经肝Ⅰ期胆道造瘘取石术
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