摘要
目的 :探讨经内镜括约肌切开 (EST)和内镜乳头气囊扩张 (EPBD)治疗胆总管结石的安全性和疗效。方法 :经EST和EPBD共治疗胆总管结石 3 2 8例 ,其中单颗结石 174例 ,2颗结石 112例 ,3颗以上结石 4 2例 (最多 1例 2 0颗结石 )。对于 <10mm结石采用EPBD治疗 ,>11mm采用EST。结果 :治疗成功 3 2 3例 ,占98.5 % ,失败 5例。其中 98例经内镜治疗后结石自然排出 ,2 0 7例采用网篮或取石球囊取出结石 ,14例采用碎石网篮碎石后排出 ,4例经震波碎石后取出。 2 2 / 3 2 3例经 2～ 3次再次取石后取净。总的并发症 2 .5 % ,其中胃肠道出血 1例 ,胆管炎 4例 ,胰腺炎 3例。 92例术后行胃肠钡餐X线检查 ,86例胆道内无钡剂返流 ,2例胆道内有积气 ,4例有钡剂返流入胆道。结论 :EST和EPBD安全 ,有效 ,并发症少 ,是目前治疗胆总管结石的重要手段之一。
Objective: To assess the safety and curative effect of endoscopic sphincterotomy (EST) and papillary balloon dilatation (EPBD) for choledocholithiasis. Methods: 328 patients with choledocholithiasis were given EST or EPBD, including single biliary stone in 174 cases, two stones in 112 cases and three stones in 42 cases (one case with 20 stones). The cases with biliary stones less than 10mm were given EPBD and the cases with biliary stones larger than 11mm were given EST treatment. Results: The treatment of EST and EPBD were successful in 323 cases (98.5%) and failed in 5 cases (1.5%). After endoscopic therapy, the choledocholithiasis in 98 cases were excluded neutrally, 207 cases were given basketball or balloon to get rid of the stones. The choledocholithiasis in 14 cases were discharged with basketball lithotripsy, in 4 cases were given lithotripsy. The choledocholithiasis in 22 of 323 cases were gotten rid of thoroughly after being treated for 2-3 times. Total complications were noted in 2.5% of these cases. Hemorrhage of gastrointestinal tract occurred in 1 case, cholangitis in 4 cases and pancreatitis in 3 cases. 92 cases were given gastroenteric barium X-ray examination, 86 cases had no barium reflux in biliary tract, 2 cases had intrabiliary banked gas, 4 cases had barium reflux in biliary tract. Conclusions: EST and EPBD are relatively safe and effective procedure in treating choledocholithiasis with few complications.
出处
《中国内镜杂志》
CSCD
2000年第1期3-6,共4页
China Journal of Endoscopy
关键词
胆总管结石
内镜
括约肌切开
乳头气囊扩张术
Choledocholithiasis
Endoscope
Sphincterotomy
Papillary Balloon Dilitation
