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内镜下括约肌切开术后的长期结果

[Long term results after endoscopic sphincterotomy].

作者信息

Seifert E, Gail K, Weismüller J

出版信息

Dtsch Med Wochenschr. 1982 Apr 23;107(16):610-4. doi: 10.1055/s-2008-1069987.

Abstract

A multicenter study of 25 centers covering 9041 endoscopic sphincterotomies showed that choledochal concrements still represent the main indication (83,9%). Circumscript papillary stenosis (10.64%) and papillary tumour(2.06%) are the next most frequent indications. Complications after endoscopic sphincterotomy may be expected in 7.55% of cases, somewhat more frequent after papillary stenoses than after choledochal concrements. The most frequent complication is haemorrhage, followed by pancreatitis, cholangitis in cases of choledochal concrements, and perforation. Mortality is around 1.12%. Late results after endoscopic sphincterotomy a satisfactory and concrement-free bile ducts are seen in 91.62%. Freedom of complaints or improvements of symptoms occur in 93.4%. Recurrent stones occur in 5.77%, restenoses were seen in 3.14%. Late results after endoscopic sphincterotomy ar worse in papillary stenosis than in choledocholithiasis. Mortality figures are twice as high and danger of perforation seems to be more frequent. Endoscopic sphincterotomy is done increasingly as an emergency measure.

摘要

一项涵盖25个中心、9041例内镜括约肌切开术的多中心研究表明,胆总管结石仍是主要适应证(83.9%)。局限性乳头狭窄(10.64%)和乳头肿瘤(2.06%)是其次最常见的适应证。内镜括约肌切开术后并发症发生率预计为7.55%,乳头狭窄后并发症发生率略高于胆总管结石后。最常见的并发症是出血,其次是胰腺炎、胆总管结石病例中的胆管炎和穿孔。死亡率约为1.12%。内镜括约肌切开术后的远期结果令人满意,91.62%的患者胆管无结石。93.4%的患者症状缓解或改善。复发性结石发生率为5.77%,再狭窄发生率为3.14%。内镜括约肌切开术后乳头狭窄的远期结果比胆总管结石更差。死亡率高出两倍,穿孔风险似乎更高。内镜括约肌切开术作为一种紧急措施的应用越来越多。

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