Sugiyama M, Atomi Y
First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611 Japan.
Gastrointest Endosc. 2001 Oct;54(4):459-63. doi: 10.1067/mge.2001.117516.
Endoscopic papillary balloon dilation (EPBD) for removal of bile duct stones tends to preserve papillary function. However, EPBD may exert beneficial or deleterious effects on gallbladder motility. This was a prospective, medium-term investigation (2 years) of the effects of EPBD on gallbladder motility.
Twelve patients with intact gallbladders (6 with and 6 without gallbladder stones) who underwent EPBD for choledocholithiasis were enrolled in this study. Gallbladder motility was examined before EPBD and at 7 days, 1 month, 1 year, and 2 years after EPBD. Gallbladder volumes, measured after fasting and after ingestion of dried egg yolk, were determined by US.
All patients were asymptomatic during the 2-year follow-up period. Before EPBD, particularly in patients with cholelithiasis, the gallbladder had a larger fasting volume and lower yolk-stimulated maximum contraction compared with normal control subjects. Seven days after EPBD, fasting volume was decreased and maximum contraction was increased, both significantly compared with pre-EPBD values and regardless of the presence or absence of gallbladder stones. At 1 month, 1 year, and 2 years after EPBD, these changes were far less evident and gallbladder function did not differ significantly from baseline.
EPBD does not adversely affect gallbladder motility in the medium-term (2 years). In terms of gallbladder motility, EPBD does not appear to increase the future risk of acute cholecystitis or gallbladder stone formation.
内镜下乳头球囊扩张术（EPBD）用于胆管结石的取出，倾向于保留乳头功能。然而，EPBD可能对胆囊运动产生有益或有害的影响。这是一项关于EPBD对胆囊运动影响的前瞻性中期研究（2年）。
12例胆囊完整的患者（6例有胆囊结石，6例无胆囊结石）因胆总管结石接受了EPBD，被纳入本研究。在EPBD前以及EPBD后7天、1个月、1年和2年检查胆囊运动。通过超声测定禁食后和摄入干蛋黄后的胆囊体积。
在2年的随访期内，所有患者均无症状。EPBD前，特别是胆石症患者，与正常对照受试者相比，胆囊禁食体积较大，蛋黄刺激后的最大收缩率较低。EPBD后7天，禁食体积减小，最大收缩率增加，与EPBD前的值相比均有显著差异，且与有无胆囊结石无关。在EPBD后1个月、1年和2年，这些变化远不那么明显，胆囊功能与基线相比无显著差异。
EPBD在中期（2年）对胆囊运动无不利影响。就胆囊运动而言，EPBD似乎不会增加未来发生急性胆囊炎或胆囊结石形成的风险。
