摘要
目的探讨壶腹周围憩室合并胆总管结石的内镜治疗技术与策略。方法回顾性分析该科1989年6月～2008年8月接受经内镜逆行胰胆管造影(ERCP)诊治患者6221例,其中,389例壶腹周围憩室合并胆总管结石的患者接受了经内镜下十二指肠乳头括约肌切开术(EST)、经内镜网篮取石术(ESR)及碎石器机械碎石及取石球囊扩张等治疗,与同时期行同样治疗的400例无壶腹周围憩室的胆总管结石患者相比较。结果 389例壶腹周围憩室合并胆总管结石的患者经内镜治疗后胆总管结石取净率97.43%(379/389),内镜治疗后无严重并发症发生,无1例死亡。结论 ERCP治疗壶腹周围憩室合并胆总管结石的关键是正确判断胆总管末端的走向,选择合理的切口和切开长度,根据憩室旁乳头和憩室内乳头的不同,选择不同的切开方式。
[Objective]To study endoscopic treatment techniques and strategy for choledocholithiasis with periampullary diverticula. [Methods]6, 221 patients who accepted endoscopic retrograde cholangiopancreatography （ERCP） in our department since 1989.6-2008.8 were retrospectively analyzed, of which, 389 cases of choledocholithiasis with periampullary diverticula underwent endoscopic sphincterotomy （EST）, endoscopic lithotripsy basket （ESR） or/and other mechanical lithotripsy treatment to extract the common bile duct stones. In the same period, 400 cases of common bile duct stones without periampullary diverticula experienced same endoscopic treatment to remove common bile duct stones. [Results]The stones were successfully removed in 389 choledocholithiasis patients and rate of stones removed completely was 97.43% one time. There was no serious complication occurred and no patient died. [Conclusion]The keys of endoscopic treatment for common bile duct stones combined periampullary diverticula is to judge the trend of end of common bile duct exactly and choose rational surgery incision and size. According to the difference of juxtapapillary diverticula and int radiverticular papilla, to choose different ways.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第5期533-535,共3页
China Journal of Endoscopy
