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 经EST和EPBD治疗胆总管结石 4 2 9例 ,其中原发性胆总管结石 178例 ,胆道术后胆总管残留或复发性结石 2 5 1例 ;单颗结石 2 2 5例 ,2颗结石 12 8例 ,3颗或 3颗以上结石 76例 ;对于 <10mm结石采用EPBD治疗 ,>10mm采用EST ;结果治疗成功 4 2 1例占 98 1% ,失败 8例 ;其中 98例经内镜治疗后结石自然排出 ,2 88例采用网篮或取石球囊取出结石 ,30例采用碎石网篮碎石后排出 ,5例经震波碎石后取出 ;36 / 4 2 9例经 2～ 3次再次取石后取净 ;总的并发症 3.0 % ,其中消化道出血 2例 ,胆管炎 4例 ,胰腺炎 7例 ;12 8例术后行胃肠钡餐X线检查 ,12 0例胆道内无钡剂返流 ,3例胆道内有积气 ,5例有钡剂返流入胆道 ;结论 EST和EPBD安全、有效 ,并发症少 。
Objective The clinical value of endoscopic sphincterotomy(EST) and papillary balloon dilatation(EPBD) in treating choledocholithiasis was studied.Methods A total of 429 patients with choledocholithiasis were performed EST or EPBD. There were primary gallstones 178 cases, residual or recurrence gallstones 251 cases in these patients including single stone(225 cases), two stones(128 cases), more than three stones(76 cases). The patients with gallstones less than 10 mm were performed EPBD and that larger than 10 mm were treated by EST. Results The treatments with EST and EPBD were successful in 421 cases(98.1%) and failed in 8 cases(1.9%). After endoscopic therapy, the gallstones in 98 cases were excluded naturally, 288 cases were performed basketball or balloon to get rid of the stones, 30 cases were discharged with basketball lithotripsy, 5 cases were performed extracorporeal shock-wave lithotripsy(ESWL). The choledocholithiasis in 36 of 429 cases were gotten rid of thoroughly after treating for 2～3 times. Complications were found in 3.0% of these cases including hemorrhage of upper gastrointestinal tract 2 cases, cholangitis 4 cases and pancreatitis 7 cases. Of these patients 128 cases were performed gastrointestinal barium X-ray examination, the results showed that 120 cases had no enterobiliary reflux, 3 cases had intrabiliary banked gas, 5 cases had barium reflux in biliary tract. Conclusion The EST and EPBD are safe and effective approches in treatment of choledocholithiasis, with fewer complications and they are the important measures for the treatment of choledocholithiasis.
出处
《生物医学工程与临床》
CAS
2002年第2期84-86,共3页
Biomedical Engineering and Clinical Medicine
关键词
内镜技术
胆总管结石治疗
应用
choledocholithiasis
endoscopy
sphincterotomy
papillary balloon dilatation
