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内镜括约肌切开术——110例患者的经验

Endoscopic sphincterotomy--experience with 110 patients.

作者信息

Misra S P, Mahapatra J, Raju G S, Sood G, Anand B S

出版信息

Indian J Gastroenterol. 1989 Oct;8(4):253-5.

PMID:2599564
Abstract

During the last two years, 116 endoscopic sphincterotomies (ES) were attempted in 110 patients. The indication for ES was choledocholithiasis in 102 (93%) patients, including 37 (36.2%) with gallbladder in situ and 65 (64%) post-cholecystectomy patients; the other 8 (7%) were performed for stricture of the lower end of the common bile duct (CBD) with cholangitis (2), insertion of nasobiliary drain (2), restenosis after previous sphincterotomy (1), stone in the cystic duct stump causing cholangitis (1), papillary stenosis (1) and post-cholecystectomy cholangitis with no obvious cause (1). ES was achieved in 113 (97.4%) attempts in 107 (97%) patients and was overall successful in 81% of patients. Of the 95 patients with choledocholithiasis in whom ES could be performed and a follow-up was available, 79 (83%) cleared their CBD. Of 98 patients with choledocholithiasis, 79 (80.6%) finally cleared their CBD of stones. Three patients developed complications, one needing emergency operation. There were no deaths. ES was found to be effective in patients with retained stones and also in patients with choledocholithiasis with gallbladder in situ, especially those who were poor surgical risk.

摘要

在过去两年中,对110例患者进行了116次内镜括约肌切开术(ES)。ES的适应症为胆总管结石,共102例(93%)患者,其中37例(36.2%)胆囊未切除,65例(64%)为胆囊切除术后患者;另外8例(7%)是因胆总管下端狭窄合并胆管炎(2例)、插入鼻胆管引流管(2例)、既往括约肌切开术后再狭窄(1例)、胆囊管残端结石引起胆管炎(1例)、乳头狭窄(1例)以及胆囊切除术后原因不明的胆管炎(1例)而进行手术。107例(97%)患者的113次手术(97.4%)成功完成了ES,总体成功率为81%。在95例可行ES且有随访资料的胆总管结石患者中,79例(83%)胆总管结石清除。98例胆总管结石患者中,79例(80.6%)最终清除了胆总管结石。3例患者出现并发症,1例需要急诊手术。无死亡病例。ES被发现对残留结石患者以及胆囊未切除的胆总管结石患者有效,尤其是手术风险高的患者。

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