Wilson P, Webster Gjm
Pancreaticobiliary Medicine, Department of Gastroenterology, University College London Hospitals, London, UK.
Frontline Gastroenterol. 2017 Apr;8(2):129-132. doi: 10.1136/flgastro-2016-100786. Epub 2017 Feb 10.
The management of bile duct stone disease is the most common indication for endoscopic retrograde cholangio-pancreatography (ERCP). The majority of cases may be resolved using standard approaches including endoscopic sphincterotomy and balloon stone extraction. Recent advances in the management of large or challenging stones has come from the clear evidence for the role of endoscopic papillary large balloon dilatation (EPLBD)/sphincteroplasty and the development of cholangioscopically directed lithotripsy. Perhaps the greatest improvement in endoscopic stone management will be achieved through the implementation of plans for more formalised training, reflection and audit of ERCP performance indicators and network-wide coordination of ERCP services.
胆管结石病的治疗是内镜逆行胰胆管造影术（ERCP）最常见的适应证。大多数病例可采用包括内镜括约肌切开术和球囊取石术在内的标准方法解决。对于大型或具有挑战性结石的治疗，最近的进展来自于内镜乳头大球囊扩张术（EPLBD）/括约肌成形术作用的确切证据以及胆管镜引导下碎石术的发展。或许，通过实施更正规的培训计划、对ERCP性能指标进行反思和审核以及在全网络范围内协调ERCP服务，内镜下结石治疗将取得最大的改善。
