小胆总管结石的综合综述。

Comprehensive review on small common bile duct stones.

机构信息

Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa 247-8533, Japan.

Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan.

出版信息

World J Gastroenterol. 2023 Apr 7;29(13):1955-1968. doi: 10.3748/wjg.v29.i13.1955.

Abstract

Common bile duct stones are among the most common conditions encountered by endoscopists. Therefore, it is well researched; however, some items, such as indications for endoscopic papillary balloon dilatation (EPBD), safety of EPBD and endoscopic sphincterotomy in patients receiving dual antiplatelet therapy or direct oral anticoagulant, selection strategy for retrieval balloons and baskets, lack adequate evidence. Therefore, the guidelines have been updated with new research, while others remain unchanged due to weak evidence. In this review, we comprehensively summarize the standard methods in guidelines and new findings from recent studies on papillary dilation, stone retrieval devices, difficult-to-treat cases, troubleshooting during the procedure, and complicated cases of cholangitis, cholecystolithiasis, or distal biliary stricture.

摘要

胆总管结石是内镜医生最常遇到的病症之一。因此,其研究较为充分;但仍有一些项目,如内镜乳头球囊扩张术(EPBD)的适应证、接受双联抗血小板治疗或直接口服抗凝剂患者行 EPBD 和内镜括约肌切开术的安全性、取石球囊和取石篮的选择策略,缺乏足够的证据。因此,指南根据新的研究进行了更新,而其他项目则因证据不足而保持不变。在本综述中,我们全面总结了指南中的标准方法和近期研究中关于乳头扩张、取石器械、难治性病例、操作过程中的故障排除以及胆管炎、胆囊结石或远端胆管狭窄复杂病例的新发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ea/10122794/493d843ce310/WJG-29-1955-g001.jpg

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