Singh V, Singh K, Kumar P, Prakash V, Rai H S, Kumar A, Agarwal B K
Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, India.
Trop Gastroenterol. 1994 Jan-Mar;15(1):19-22.
Eighty-seven patients underwent endoscopic sphincterotomy (ES) for common bile duct (CBD) stones. Out of these, 66 patients had post-cholecystectomy CBD stones and 21 had CBD stones with gall bladder 'in situ'. In post-cholecystectomy group, 15 patients had 'T' Tube 'in situ'. The presenting symptoms in the post-cholecystectomy group were: pain abdomen, jaundice and cholangitis in 51, 20 and 11 patients respectively. The fifteen patients with 'T' tube used to experience pain after clamping of 'T' tube. Those with gall bladder 'in situ' had cholangitis in 12 and jaundice only in 9 patients. CBD clearance was achieved in 80 patients (91.95%). The sphincterotomy cut had to be extended in 19 patients. There was no mortality following sphincterotomy. Nine patients (10.3%) had minor complications such as bleeding (4), cholangitis (3), pancreatitis and impaction of Dormia basket in one patient each. Thus ES is a safe and effective treatment for CBD stones with or without gall bladder/'T' tube 'in situ'.
87例患者因胆总管结石接受了内镜括约肌切开术(ES)。其中,66例患者为胆囊切除术后胆总管结石,21例患者为胆囊存在时的胆总管结石。在胆囊切除术后组中,15例患者留置了“T”管。胆囊切除术后组的主要症状分别为:51例患者出现腹痛,20例患者出现黄疸,11例患者出现胆管炎。15例留置“T”管的患者在夹闭“T”管后出现疼痛。胆囊存在的患者中,12例出现胆管炎,仅9例出现黄疸。80例患者(91.95%)实现了胆总管结石清除。19例患者的括约肌切开切口必须延长。括约肌切开术后无死亡病例。9例患者(10.3%)出现轻微并发症,如出血(4例)、胆管炎(3例)、胰腺炎,1例患者出现Dormia网篮嵌顿。因此,ES对于胆囊存在或不存在/留置“T”管的胆总管结石是一种安全有效的治疗方法。