内镜下十二指肠乳头肌部分切开并气囊扩张取石术与胆管内压力变化的相关研究  

Related research on removing stones by EST partly with EPBD and changes of choledochal inner pressure

作　　者：傅继宁[1] 孙亚新[1] 杨维生[1] 李亮[1] 季辉[1] 

机构地区：[1]吉林省四平市中心医院普外科,吉林四平136000

出　　处：《中国内镜杂志》2005年第4期385-387,共3页China Journal of Endoscopy

摘　　要：目的探讨应用内镜治疗胆总管结石时,在减少内镜治疗并发症的同时保留乳头括约肌功能。方法应用十二指肠镜行十二指肠乳头括约肌部分切开(endoscopicshincterotomy,EST)并气囊扩张(endo-scopicpapillaryballoondilatation,EPBD)治疗胆总管结石108例,同时进行胆总管内压的测定,钡餐透视,观察有无胆道逆流情况,以鉴定乳头括约肌功能。结果取石成功率98.15%,1次取净结石达86.79%,无出血、穿孔等严重并发症。远期观察胆总管内压力无明显改变,钡餐透视无钡剂胆道逆流情况。结论内镜行十二指肠乳头括约肌部分切开并气囊扩张的方法治疗胆总管结石,能够达到与EST的同样效果,弥补了EPBD的不足,在保留了十二指肠乳头括约肌的功能的同时减少了内镜治疗的并发症。[Objective]Probe into treating choledocholithiasis by means of performing endoscopy, reduce complication in endoscopy, remain the nature of duodenal papillary sphincter. Perform endoscopic sphincterotomy (EST) partly with endoscopic papillary balloon dilatation (EPBD), we had treated 108 cases of choledecholithiasis, at the same time, measured the choledochal inner pressure and observed whether there is biliary passage counter current using barium meal examination to determine the function of papillary muscle. Successful rate was 98.15%, successful rate of taking stones at one attempt was 86.79%. Serious camplication such as bleeding and perforation don′t exit. Choledochal inner pressure has no obvious change and the biliary passage counter current hasn′t been seen by using barium meal examination for long time. [Conclusions] Treatment for choledocholithiasis by means of performing duodenal sphincterotomy partly with balloon dilation can get the same effect as that of using EST. The method makes up the insufficiency in EPBD, retains the function of duodenal papillary sphincter and reduces the complications in endoscopy.

关 键 词：乳头切开 乳头扩张 胆总管结石 胆总管内压 

分 类 号：R656.6[医药卫生—外科学]