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经皮经肝胆道球囊扩张术治疗胆总管结石的临床研究:一种新方法

[Clinical study of percutaneous transhepatic balloon dilation:a novel procedure for common bile duct stone].

作者信息

Li Yu-liang, Geng Jian-li, Jia Yun-ming, Lu Hong-liang, Wang Wei, Liu Bin, Wang Wu-jie, Chang Hai-yang, Wang Yong-zheng, Li Zheng

机构信息

Department of Interventional Medicine, the Second Hospital of Shandong University,Jinan 250033, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2013 Dec 3;93(45):3586-9.

PMID:24534307
Abstract

OBJECTIVE

To investigate the safety and efficacy of percutaneous transhepatic balloon dilation for the removal of common bile duct stone.

METHODS

Sixty-eight cases with common bile duct stone treated with percutaneous transhepatic balloon dilation in our department from July 2008 to April 2011 were analyzed retrospectively.Record CA19-9, total bilirubin, indirect bilirubin and albumin before the procedure, 1 week and 1 month later. Check if immediate complications occurs, including hemorrhage, perforation, pancreatitis and cholangitis. During the following up for 2 years, stone recurrence, reflux cholangitis and other long-term complications were observed. Analyze the changes of indicators between preoperative and postoperative and the correlation.

RESULTS

All of the 68 patients were treated successfully.53 patients underwent one procedure, and 15 patients received twice or more times of procedures. CA19-9, TBIL and IBIL decreased significantly 1 week later and 1 month later compared with those before the procedure, while ALB was opposite.Incidences of biliary tract infection, hemorrhage, and pancreatitis were 4.4% (3/68), 2.9% (2/68) and 1.5% (1/68) respectively.No severe complications occurred, including perforation of gastrointestinal or biliary tract.Incidences of recurrent stone and reflux cholangitis were 14.7% (10/68) and 5.9% (4/68) in two years after the procedure.

CONCLUSION

Percutaneous transhepatic balloon dilation is a safe and effective procedure for patients with common bile duct stone. For the cases which could not be handled with endoscopic procedures, it provides a new therapeutic approach.

摘要

目的

探讨经皮经肝胆道球囊扩张取石术的安全性及有效性。

方法

回顾性分析2008年7月至2011年4月在我科接受经皮经肝胆道球囊扩张取石术治疗的68例胆总管结石患者。记录术前、术后1周及1个月时的CA19-9、总胆红素、间接胆红素及白蛋白水平。检查是否发生即刻并发症,包括出血、穿孔、胰腺炎及胆管炎。在随访的2年中,观察结石复发、反流性胆管炎及其他远期并发症情况。分析术前、术后指标变化及相关性。

结果

68例患者均治疗成功。53例患者接受1次手术,15例患者接受2次或更多次手术。与术前相比,术后1周及1个月时CA19-9、总胆红素和间接胆红素显著下降,而白蛋白则相反。胆道感染、出血及胰腺炎的发生率分别为4.4%(3/68)、2.9%(2/68)和1.5%(1/68)。未发生包括胃肠道或胆道穿孔在内的严重并发症。术后2年结石复发率和反流性胆管炎发生率分别为14.7%(10/68)和5.9%(4/68)。

结论

经皮经肝胆道球囊扩张取石术对于胆总管结石患者是一种安全有效的手术方法。对于无法通过内镜手术处理的病例,它提供了一种新的治疗途径。

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