Jakobeit C, Greiner L, Schumacher R, Johanns W, Janssen J, Sulliga M, Schnabel R, Welp L B, Pumplün B
Medizinische Klinik, Johanniter-Krankenhaus, Radevormwald, Germany.
Leber Magen Darm. 1996 Jul;26(4):201-3.
In 17 patients (8 men, 9 women; mean age 61.5 years) with problematic bile-duct stones (papilla endoscopically inaccessible, residual bile-duct stones after recent laparoscopic cholecystectomy or age below 25 years) the chances of successful treatment by ESWL without sphincterotomy were examined. In 15 patients with solitary stones measuring up to 14 mm "pulverization-ESWL" produced complete freedom from stones after spontaneous migration of fragments through the intact papilla. Only two patients with two ductal stones measuring up to 15 mm still had residual fragments in the bile duct after treatment. The ideal stone for ESWL without sphincterotomy is thus the solitary bile-duct stone measuring up to 14 mm. Before performing a high-risk sphincterotomy, before re-operation and in young patients one should therefore always examine whether ESWL without sphincterotomy is indicated.
对17例（8例男性，9例女性；平均年龄61.5岁）患有疑难胆管结石（乳头内镜无法到达、近期腹腔镜胆囊切除术后残留胆管结石或年龄低于25岁）的患者，研究了不进行括约肌切开术而通过体外冲击波碎石术（ESWL）成功治疗的可能性。15例患有直径达14毫米的孤立结石的患者，在结石碎片通过完整乳头自然排出后，“粉碎性ESWL”使结石完全清除。只有2例患有两颗直径达15毫米胆管结石的患者在治疗后胆管内仍有残留碎片。因此，不进行括约肌切开术的ESWL的理想结石是直径达14毫米的孤立胆管结石。因此，在进行高风险的括约肌切开术之前、再次手术之前以及年轻患者中，应始终检查是否适合进行不进行括约肌切开术的ESWL。
