Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Dig Endosc. 2010 Jul;22 Suppl 1:S69-75. doi: 10.1111/j.1443-1661.2010.00953.x.
Endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD) are endoscopic techniques that are used for the removal of bile duct stones. Although EST and EPBD have become established techniques, occasionally the management of bile duct stones may be difficult in cases of large stones, multiple stones, and tapering or tortuosity of the distal common bile duct. In such patients, extracorporeal shock wave lithotripsy, mechanical lithotripsy or electrohydraulic lithotripsy, laser lithotripsy, or surgical intervention may be necessary. Furthermore, recently EST plus a large papillary balloon dilation has been popular for the treatment of difficult bile duct stones. Currently, endoscopic lithotripsy for bile duct stones seems to be a promising standard technique.
内镜下括约肌切开术（EST）和内镜下乳头球囊扩张术（EPBD）是用于取除胆管结石的内镜技术。尽管 EST 和 EPBD 已成为既定技术，但在大结石、多发结石以及胆总管末端变细或迂曲的情况下，胆管结石的处理可能具有挑战性。在这些患者中，可能需要进行体外冲击波碎石术、机械碎石术或液电碎石术、激光碎石术或手术干预。此外，最近 EST 加大型乳头球囊扩张术已广泛用于治疗困难的胆管结石。目前，内镜下碎石术似乎是治疗胆管结石的一种有前途的标准技术。
