经内镜括约肌切开或气囊扩张治疗胆总管结石

APPLICATION OF ENDOSCOPIC SPHINCTEROTOMY OR PAPILLARY BALLOON DILATATION FOR CHOLEDOCHOLITHIASIS

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）治疗胆部管结石的安全性和疗效。方法：经ＥＳＴ和ＥＰＢＤ共治疗胆总结石３２８例，其中单颗结石１７４例，２颗结石１１２例，３颗粒以上结石４２例（最多１例２０颗结石）。对于〈１０ｍｍ结石采用ＥＰＢＤ治疗，〉１１ｍｍ采用ＥＳＴ。结果：治疗成功３２３例，占９８．５％，失峁５例，其中９８例经内镜治疗后结石自然排出，２０７例采用网复或取石球囊取出

Abstract:

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.