Bergman J J, Tytgat G N, Huibregtse K
Dept. of Gastroenterology, Academic Medical Center, University of Amsterdam, The Netherlands.
Scand J Gastroenterol Suppl. 1998;225:59-65. doi: 10.1080/003655298750027245.
Endoscopic balloon dilatation (EBD) of the biliary sphincter may be an alternative to endoscopic sphincterotomy (EST) for removal of bile duct stones. After EBD of the biliary sphincter to a diameter of 8 mm, stones are removed according to standard guidelines. In the event that stone removal fails after EBD, an additional EST is performed. The overall success rate of stone removal after EBD (90%) is comparable to that of EST. After EBD, an additional EST and mechanical lithotripsy are required in 10% and 30% of patients, respectively. In patients with bile duct stones < 10 mm and a stone number < or = 3, EBD is nearly always successful without the need for additional EST or mechanical lithotripsy. Pancreatitis post-EBD occurs at a rate of 5-7%, which is not significantly different from that after EST. Significant bleeding post-EBD has not been observed in over 400 patients undergoing EBD. EBD is a valuable alternative to EST, especially in patients with smaller bile duct stones and in patients with haemostatic disorders.
胆管括约肌内镜下球囊扩张术（EBD）可作为内镜下括约肌切开术（EST）的替代方法用于胆管结石的取出。将胆管括约肌通过EBD扩张至直径8mm后，按照标准指南取出结石。若EBD后结石取出失败，则需额外进行EST。EBD后结石取出的总体成功率（90%）与EST相当。EBD后，分别有10%和30%的患者需要额外进行EST和机械碎石术。对于胆管结石<10mm且结石数量<或 = 3的患者，EBD几乎总能成功，无需额外进行EST或机械碎石术。EBD后胰腺炎的发生率为5 - 7%，与EST后发生率无显著差异。在接受EBD的400多名患者中，未观察到EBD后出现严重出血。EBD是EST的一种有价值的替代方法，尤其适用于胆管结石较小的患者和有止血障碍的患者。
