内镜括约肌切开术或乳头球囊扩张术治疗胆总管结石

Endoscopic sphincterotomy or papillary balloon dilatation for choledocholithiasis.

作者信息

Yao Li-Qing, Zhang Yi-Qun, Zhou Ping-Hong, Gao Wei-Dong, He Guo-Jie, Xu Mei-Dong

机构信息

General Surgery Department, Zhongshan Hospital, Fu Dan University, Shanghai 200032, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2002 Feb;1(1):101-5.

PMID:14607635

Abstract

OBJECTIVE

To assess the safety and effect of endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD) for choledocholithiasis.

METHODS

328 patients with choledocholithiasis were subjected to EST or EPBD; they included 174 patients with single stone, 112 patients with two stones and 42 patients with three stones (one patient with 20 stones). Patients with stones less than 10 mm in diameter underwent EPBD and those with stones larger than 11 mm in diameter underwent EST.

RESULTS

EST and EPBD succeeded in 323 patients (98.5%), and failed in 5. Stones in 98 patients were excluded spontaneously after endoscopic therapy. 207 patients were subjected to basket or balloon stone extraction. Stones in 14 patients were discharged by basket lithotripsy. Four patients were given wave lithotripsy. Stones in 22 of the 323 patients were extracted thoroughly after 2-3 times attempts. Total complications were noted in 2.5% of the patients. Hemorrhage from the gastrointestinal tract was seen in one patient, cholangitis in 4 patients, and pancreatitis in 3 patients. In 92 patients receiving digestive tract barium X-ray examination, 86 developed no barium reflux to the baliary tract, 2 pneumobilia, 4 barium reflux to the biliary tract.

CONCLUSION

EST and EPBD are relatively safe and effective in treatment of choledocholithiasis, and have few complications.

摘要

目的

评估内镜括约肌切开术（EST）和内镜乳头气囊扩张术（EPBD）治疗胆总管结石的安全性和效果。

方法

328例胆总管结石患者接受了EST或EPBD治疗；其中包括174例单颗结石患者、112例两颗结石患者和42例三颗结石患者（1例有20颗结石）。直径小于10mm的结石患者接受EPBD，直径大于11mm的结石患者接受EST。

结果

EST和EPBD在323例患者中成功（98.5%），5例失败。98例患者的结石在内镜治疗后自行排出。207例患者接受了网篮或气囊取石。14例患者通过网篮碎石排出结石。4例患者接受了超声碎石。323例患者中有22例在2 - 3次尝试后结石被彻底取出。总并发症发生率为2.5%。1例患者出现胃肠道出血，4例患者发生胆管炎，3例患者发生胰腺炎。在92例接受消化道钡餐X线检查的患者中，86例未出现钡剂反流至胆道，2例出现气肿性胆囊炎，4例出现钡剂反流至胆道。