内镜下括约肌切开术及乳头球囊扩张术治疗胆管结石

Endoscopic sphincterotomy and papillary balloon dilation for bile duct stones.

作者信息

Toda Nobuo, Saito Keiji, Wada Ryou, Kawabe Takao, Shiratori Yasushi, Mitsushima Toru, Omata Masao

机构信息

Division of Gastroenterology, Kameda General Hospital, University Of Tokyo, Japan.

出版信息

Hepatogastroenterology. 2005 May-Jun;52(63):700-4.

PMID:15966186

Abstract

BACKGROUND/AIMS: There are many reports of the results of endoscopic sphincterotomy (EST) for common bile duct stones. Recently, there were several reports on the results of endoscopic papillary balloon dilation (EPBD) for this condition. However, there have been few reports about a comparison between EST and EPBD.

METHODOLOGY

Between Oct. 1994 and Dec. 1998, 196 consecutive patients underwent 102 EST or 94 EPBD.

RESULTS

EST and EPBD were successful in 100 of 102 (98.0%), and all 94 patients. Bile duct clearance was achieved in 88 (88.0%) in the EST group and 88 (95.7%) in the EPBD group. Early complications occurred in 13 (13.0%: 3 acute pancreatitis, 4 cholangitis, 2 cholecystitis, 2 bleeding, 2 perforation) in the EST group and 16 (17.0%: 7 acute pancreatitis, 4 cholangitis, 4 cholecystitis, 1 basket impaction) in the EPBD group. Three patients (1 bleeding, 2 perforations) underwent emergent surgery after EST.

CONCLUSIONS

The rate of bile duct clearance with EPBD was comparable to that with EST. Early complications did not differ between EST and EPBD. The use of EST tended to be associated with a lower incidence of acute pancreatitis, a higher incidence of bleeding, and a higher rate of perforation.

摘要

背景/目的：关于内镜括约肌切开术（EST）治疗胆总管结石的结果已有很多报道。最近，也有几篇关于内镜乳头气囊扩张术（EPBD）治疗这种疾病结果的报道。然而，关于EST和EPBD比较的报道却很少。

方法

1994年10月至1998年12月期间，196例连续患者接受了102例EST或94例EPBD。

结果

102例EST中有100例（98.0%）成功，94例EPBD全部成功。EST组88例（88.0%）实现胆管清除，EPBD组88例（95.7%）实现胆管清除。EST组发生早期并发症13例（13.0%：3例急性胰腺炎、4例胆管炎、2例胆囊炎、2例出血、2例穿孔），EPBD组发生16例（17.0%：7例急性胰腺炎、4例胆管炎、4例胆囊炎、1例网篮嵌顿）。3例患者（1例出血、2例穿孔）在EST后接受了急诊手术。