研究目的
详细阐述经皮肝穿刺胆道激光碎石术的技术原理及其在临床实践中用于治疗肝内胆管结石或常规方法难治性胆总管结石的应用价值。
研究成果
经皮肝穿刺胆道激光碎石术对于不适合常规治疗的患者,在经验丰富的介入放射科医师操作下是一种安全有效的替代方案。术前规划对手术成功至关重要。
研究不足
当存在活动性胆管炎时,由于感染播散和脓肿形成的风险,不应进行该手术。激光碎石术对胆泥或铸型物质也无效。多个肝段存在多发结石的患者通常需要重复手术才能实现完全取石。
1:实验设计与方法选择:
该手稿详细描述了经皮肝穿刺胆道激光碎石术技术,包括使用钬:YAG激光进行结石粉碎。
2:样本选择与数据来源:
选取了因结石导致具有临床意义的胆道梗阻且不适合ERCP治疗的患者。
3:实验设备与材料清单:
包括钬:YAG激光、胆道镜、导管、导丝、鞘管和扩张器。
4:实验步骤与操作流程:
描述了从患者准备到术后护理的逐步操作过程。
5:数据分析方法:
未明确提及,但以结石清除率和最小并发症作为成功衡量标准。
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Olympus CHF – Type CB30S Choledocho?berscope
CB30S
Olympus
Used for direct visualisation of the biliary tree during the procedure.
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holmium: YAG laser
2100 nm
Used for fragmenting biliary calculi by vaporising water particles on and in the calculi.
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Cook Aprima Access Set
Aprima Set
Cook Medical
Used for primary biliary access.
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GlideWire
150 cm 0.035 in hydrophilic angled-tip
Terumo
Used to navigate the biliary tree.
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Amplatz wire
145 cm 0.035 in
Cook Medical
Used as a support wire once the target strictures have been crossed and the small bowel accessed.
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Britetip sheath
11 Fr or 12 Fr 23-cm
Cordis
Inserted into the liver to allow room for the drainage of irrigation ?uid around the cholangioscope.
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Niti-S covered removable metallic stent
Taewoong Medical
Used to facilitate calculus clearance and to help prevent recurrence.
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Trapezoid RX Wire-guided Retrieval Basket
Boston Scientific
Used for basket extraction of calculi fragments.
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