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一种集成括约肌切开刀和扩张球囊导管的内镜设备治疗胆总管结石的疗效(附视频)

Efficacy of an Endoscopic Device Integrating a Sphincterotome and a Dilation Balloon Catheter for the Treatment of Choledocholithiasis (with Video).

作者信息

Hanatani Jun-Ichi, Kitagawa Koh, Asada Shohei, Motokawa Yuki, Osaki Yui, Iwata Tomihiro, Fujinaga Yukihisa, Nishimura Norihisa, Kaji Kosuke, Sato Shinya, Namisaki Tadashi, Mitoro Akira, Yoshiji Hitoshi

机构信息

Department of Gastroenterology, Nara Medical University, Nara 6348522, Japan.

Division of Endoscopy, Nara Medical University, Nara 6348522, Japan.

出版信息

J Clin Med. 2025 Aug 22;14(17):5930. doi: 10.3390/jcm14175930.

Abstract

The combined techniques of endoscopic sphincterotomy followed by endoscopic papillary balloon dilation (ESBD) and endoscopic sphincterotomy followed by endoscopic papillary large balloon dilation (ESLBD) have gained popularity for the endoscopic treatment of choledocholithiasis. However, the conventional approach to these procedures requires two separate devices, a sphincterotome and a balloon catheter, which can complicate and prolong the procedure. We herein evaluated a novel integrated device combining a sphincterotome and balloon catheter developed to improve the efficiency of ESBD and ESLBD. This retrospective study compared the clinical outcomes of patients with choledocholithiasis who were treated using conventional sphincterotome and balloon catheters ( = 106) and those who were treated using the integrated device ( = 54). Overall complete stone removal rates (99.1% vs. 100%) and adverse event incidence (12.3% vs. 13.0%) were comparable between the two groups. However, the integrated device significantly reduced total procedure time (40 vs. 27 min, = 0.01), use of mechanical lithotripter (50.0% vs. 22.2%, < 0.01), total number of procedures required. Complete stone removal rates and safety were comparable between the two groups. However, the novel integrated device may enhance the efficiency of common bile duct stone removal through ESBD and ESLBD because it eliminates the need to prepare and exchange separate devices.

摘要

内镜括约肌切开术联合内镜乳头球囊扩张术(ESBD)以及内镜括约肌切开术联合内镜乳头大球囊扩张术(ESLBD)这两种联合技术在内镜治疗胆总管结石方面已得到广泛应用。然而,这些手术的传统方法需要两种单独的设备,即括约肌切开刀和球囊导管,这可能会使手术复杂化并延长手术时间。我们在此评估了一种新型的集成设备,该设备将括约肌切开刀和球囊导管结合在一起,旨在提高ESBD和ESLBD的效率。这项回顾性研究比较了使用传统括约肌切开刀和球囊导管治疗的胆总管结石患者( = 106)与使用集成设备治疗的患者( = 54)的临床结果。两组的总体结石完全清除率(99.1%对100%)和不良事件发生率(12.3%对13.0%)相当。然而,集成设备显著缩短了总手术时间(40对27分钟, = 0.01),减少了机械碎石器的使用(50.0%对22.2%, < 0.01),以及所需的总手术次数。两组的结石完全清除率和安全性相当。然而,这种新型集成设备可能会提高通过ESBD和ESLBD清除胆总管结石的效率,因为它无需准备和更换单独的设备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/651f/12429350/81c0fed1f967/jcm-14-05930-g001.jpg

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