摘要
目的评价塑料内支架治疗难取性胆总管结石的疗效。方法采用常规方法行ERCP造影,对48例难取性胆总管结石患者(35例为巨大结石,8例结石伴下端胆管狭窄,5例结石伴乳头过小)在导丝引导下行放置8.5F塑料胆道内支架1根治疗。结果3个月后第2次ERCP检查时发现12例结石消失;23例结石直径变小1/2以上或成碎片状,经网篮或气囊顺利取出;13例结石无明显变化,行更换塑料内支架治疗并B超随访,一旦发现结石明显变小,即再次ERCP+取石。经平均2.3次内镜下治疗,95.8%(46/48)患者结石取净。期间未发生与ERCP或留置支架相关的严重并发症。结论留置塑料内支架是治疗难取性胆总管结石简单有效的方法。
[Objective] To evaluate the efficacy of plastic stents in the management of difficult common bile duct （CBD） stones. [Methods] 48 patients with difficulty to extract CBD stones after ERCP were included in this study （35 patients with large CBD stones and 8 patients with narrowing of the distal bile duct and 5 patients with too small Vater＇s papilla）. A 8.5F plastic stent was inserted into the CBD of all the subjects, respectively, over a guidewire by the standard way. [Results] In 12 of the 48 patients, ERCP 3 months after stent placement revealed no stones in the CBD. In 23 of the 48 patients, repeat ERCP revealed that the stones became smaller to the extent of less than a half or became stone fragments that were easily extracted by using balloons or baskets. 13 patients continued to have large stones at the second ERCP treatment, then replacement of a new stent with the same style and follow-up throught ultrasonography were performed. Further endoscopic treatments were performed immediately when the stones became smaller enough. 95.8%（46/48） difficult CBD stones were eventually cleared through average 2.3 times endoscopic treatment. There were no severe complications related to ERCP or stent placement. [ Conclusion ] Placement of plastic biliary stents is a simple and effective measure in the treatment of difficult CBD stones.
出处
《中国内镜杂志》
CSCD
北大核心
2008年第1期61-63,共3页
China Journal of Endoscopy
关键词
难取性胆总管结石
塑料内支架
difficult common bile duct stone
plastic bihary stents
