摘要
目的探讨对内镜逆行性胰胆管造影(ERCP)术后伴有十二指肠乳头旁憩室的患者采用内镜下胆道塑料支架置入引流术(ERBD)治疗复发性胆总管结石的效果。方法将我院2012年8月至2014年8月胆总管结石复发且合并乳头旁憩室的18例患者随机分为支架组和对照组,支架组9例患者内镜下取净结石后留置塑料支架,对照组9例患者取净结石后留置鼻胆管引流,比较两组症状性胆总管结石复发的间隔时间和并发症发生率。结果 18例患者随访至2015年3月,支架组与对照组相比平均复发间隔时间延长[(7.19±1.42)个月vs(6.19±1.31)个月],但差异无统计学意义(P=0.140);两组患者并发症发生率的差异无统计学意义(P=1.000)。结论对于合并乳头旁憩室、ERCP术后反复再生胆总管结石的患者,取净结石后置入胆道塑料支架虽然不能显著延长再次出现症状的间隔时间,但该方法安全有效,可作为无法耐受手术或拒绝手术的患者的一种治疗选择。
Objective To evaluate the efficacy of endoscopic biliary drainage by plastic stent for patients with recurrent choledocholithiasis complicated with juxtapapillary diverticulum （JPD） after undergone ERCP for common bile duct stone removal. Methods From Aug. 2012 to Aug. 2014, 18 cases with recurrent choledocholithiasis complicated with JPD in our hospital were randomly divided into two groups, 9 cases in the stent group underwent stent placement after completely stone removal, while 9 cases in the control group received endoscopic nasobiliary drainage after bile duct clearance. The recurrent interval of symptomatic choledocholithiasis and complication rate between the two groups were compared. Results All 18 patients were followedup to Mar. 2015. Compared with the control group, the stent group had a longer average recurrent interval period [（7.19 ± 1.42） mon vs （6.19 ± 1.31） mon], but this result was not statistically significant （P=0.140）. The complication rate had not significantly difference between two groups （P=1.000）. Conclusion For patients who suffered from recurrent choledocholithiasis complicated with JPD after ERCP, even though the recurrent interval may not be prolonged significantly, endoscopic biliary drainage by plastic stent is safe, which can be an alternative for patients who can not tolerate or reject operation.
出处
《肝胆胰外科杂志》
CAS
2015年第6期490-493,共4页
Journal of Hepatopancreatobiliary Surgery
基金
上海中医药大学附属普陀医院培英计划(2013SR137II)
上海中医药大学后备业务专家培养计划(B-X-76)
