内镜下胆管括约肌切开术治疗伴有或不伴有胆管结石的 1 型胆系功能障碍（乳头狭窄）。
The role of endoscopic biliary sphincterotomy for the treatment of type 1 biliary dysfunction (papillary stenosis) with or without biliary stones.
机构信息
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA.
Department of Surgery, Detroit Medical Center/Wayne State University, 4201 St Antoine, Suite 6C-UHC, Detroit, MI 48201, USA.
出版信息
Am J Surg. 2014 Jan;207(1):65-9. doi: 10.1016/j.amjsurg.2013.04.007. Epub 2013 Sep 24.
BACKGROUND
This study assesses the safety and effectiveness of endoscopic biliary sphincterotomy (ES) in the treatment of papillary stenosis (PS) with and without biliary stones.
METHODS
The records of all patients who had endoscopic retrograde cholangiopancreatography (2,689 patients) from January 1, 1991, to August 1, 2010, were reviewed. There were 117 patients with PS who had ES.
RESULTS
All patients had biliary pain, a dilated common bile duct (CBD) with a maximum diameter of 10 to 25 mm, and elevated liver function tests. There were 46 patients who had prior cholecystectomy of whom 20 patients had CBD stones. The remaining 71 patients had no prior biliary surgery; there were no biliary stones in 14 patients. All patients were symptom free after ES with or without CBD stone retrieval.
CONCLUSIONS
ES is the optimal treatment for PS in patients with or without biliary stones. ES eliminates pain, corrects CBD dilation, and restores LFTs to normal.
背景
本研究评估了内镜下胆管括约肌切开术（ES）治疗伴有和不伴有胆管结石的乳头狭窄（PS）的安全性和有效性。
方法
回顾了 1991 年 1 月 1 日至 2010 年 8 月 1 日期间所有接受内镜逆行胰胆管造影（2689 例患者）的患者记录。共有 117 例 PS 患者接受了 ES。
结果
所有患者均有胆绞痛、胆总管（CBD）扩张，最大直径为 10-25mm，肝功能检查升高。46 例患者有胆囊切除术史，其中 20 例有 CBD 结石。其余 71 例患者无胆道手术史；14 例患者无胆管结石。所有患者在 ES 治疗后均无症状，无论是否取出 CBD 结石。
结论
ES 是伴有或不伴有胆管结石的 PS 患者的最佳治疗方法。ES 可消除疼痛、纠正 CBD 扩张，并使肝功能检查恢复正常。
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