摘要
目的探讨内镜下不同大小乳头括约肌扩张术治疗胆总管结石的效果及安全性。方法回顾性分析2016年1月~2017年12月我院收治的119例胆总管结石患者的资料。按手术方式将患者分为十二指肠乳头括约肌切开组(EST组,n=61)、十二指肠乳头括约肌小切开+小扩张组(sEST+EPBD组,球囊直径≤9 mm,n=26)、十二指肠乳头括约肌小切开+大扩张组(sEST+EPLBD组,10 mm≤球囊直径<15 mm,n=32)。分析各组患者的手术成功率、机械碎石率及术后近期并发症发生情况。结果sEST+EPLBD组、sEST+EPBD组患者的手术成功率(96.8%、84.6%)均高于EST组(75.4%),差异有统计学意义(P<0.05)。sEST+EPLBD组、sEST+EPBD组患者的机械碎石率(12.5%、15.4%)均低于EST组(34.4%),差异有统计学意义(P<0.05);三组患者的术后出血、穿孔、胰腺炎及胆管炎发生率比较,差异均无统计学意义(P>0.05)。结论内镜下乳头括约肌球囊扩张术(球囊直径<15 mm)治疗胆总管结石是安全、有效的。
Objective To investigate the effect and safety of different extent endoscopic papillary balloon dilation in the treatment of common bile duct stones.Methods Data of 119 patients with common bile duct stones admitted to our hospital from January 2016 to December 2017 were retrospectively analyzed.According to the surgery,patients were be divided into the duodenal papilla sphincter incision group(EST group,n=61),the duodenal papilla sphincter small incision+small expansion group(sEST+EPBD group,balloon diameter≤9 mm,n=26),the duodenal papilla sphincter small incision+big expansion group(sEST+EPLBD group,10 mm≤balloon diameter<15 mm,n=32).The surgical success rate,mechanical lithotripsy rate and recent postoperative complications were analyzed.Results The surgical success rates of sEST+EPLBD group and sEST+EPBD group(96.8%,84.6%)were higher than that in EST group(75.4%),the differences were statistically significant(P<0.05).The rates of mechanical gravel in the sEST+EPLBD group and sEST+EPBD group(12.5%,15.4%)were lower than that of EST group(34.4%),the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidence of postoperative hemorrhage,perforation,pancreatitis and cholangitis among the three groups(P>0.05).Conclusion Endoscopic papillary balloon dilation(balloon diameter<15 mm)is safe and effectiveness in the removal of common bile duct stones.
作者
叶艳清
廖跃光
谢军
吴雄建
YE Yan-Qing;LIAO Yue-Guang;XIE Jun;WU Xiong-Jian(Department of Gastroenterology,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou 341000,China)
出处
《中国当代医药》
2020年第14期82-85,共4页
China Modern Medicine
基金
江西省赣州市指导性科技计划基金资助项目(GZ 2018ZSF024)。
