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）治疗胆总管结石的临床应用价值。方法胆总管结石160例中,男94例,女66例。年龄24～80岁,平均59.1岁。其中,65岁以上60例,占37.5%。胆囊结石合并胆总管结石21例,单纯胆总管结石29例,胆囊切除术后胆总管结石110例。结石最大径〈1.0 cm 72例,1.0～2.0 cm 68例,〉2.0 cm 20例。44例合并乳头旁憩室,对于〈10 mm结石采用EPBD治疗,〉10 mm采用EST。结果91例经内镜乳头括约肌切开（EST）,69例采用内镜EPBD。自然排出者30例（18.7%）;采用网篮或取石球囊取出结石有100例（62.5%）,其中6例2次取石取尽,5例残留结石行外科手术治疗;采用碎石网篮碎石后取出结石者25例（15.7%）,其中单颗结石4例,多发性结石10例。13例1次碎石取出,10例2次取出,2例经3次内镜取石取净。1例继发急性胆管炎,4例急性胰腺炎。本组无消化道穿孔及死亡。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。
Objective To discuss the treatment value of endoscopic sphineterotomy（EST） and endoscopic papillary bal- loon dilatation（EPBD） in common bile duct calculus. Methods There were 160 cases of such patient in which male was in 94, female was in 66 with age of 24- 80 years old. There was about 37.5% over 60 year old. There were 21 cases combined calculus in cyst and bile duct, 29 cases simple common bile duct calculus and 110 cases after cyst re- section. The calculus was less than 1 cm in 72 cases, 1 - 2 cm in 68 cases and larger than 2cm in 20 cases. Results EPBD was used for those less than lcm in 69 cases and EST was used for those more than 1 cm in 91 cases. There were 30 cases of nature expelled, 100 cases with net in which 6 cases underwent twice and other 5 cases underwent operation after endoscope. There were 1 case of secondary cholangitis and 1 case of acute pancreatitis without perforation and death. Conclusion EST and EPBD might be safety, effectively and less complication to treat choledocholithiasis.
出处
《黑龙江医学》
2008年第10期723-724,共2页
Heilongjiang Medical Journal
