EST治疗胆总管结石10例分析  

ENDOSCOPIC SPHINCTEROTOMY TREATING COMMON BILE DUCT STONE: ANALYSIS OF 1O CASES

作　　者：朱家沂[1] 严正[1] 王亚东[1] 

机构地区：[1]泰州市人民医院,泰州225300

出　　处：《江苏临床医学杂志》1998年第6期472-474,共3页Journal of Jiangsu Clinical Medicine

摘　　要：为了提高经内镜乳头括约肌切开术（EST）的治疗水平，总结了10例胆总管2cm以下残余结石患者行EST治疗的资料。其中1枚结石7例、多发性结石3例，伴Oddi括约肌炎性狭窄2例，伴慢性服源性胰腺炎1例，伴AOSC1例，2例为毕Ⅱ式胃切除术后患者。操作开始先行ERCP检查，根据情况选用Classen刀或自制针刀，切开乳头1．0～2．0cm。结果8例切开成功，2例发生结石嵌顿转外科手术。认为掌握合适的切开长度是EST治疗胆总管结石成功的关键之一，凡乳头不能满意插入切开刀者，应选用针刀先作预备性切开，而后再用标准的切开刀完成切开术，对毕Ⅱ式胃切除术后患者可改用前规式胃镜作EST。The materials of endoscopic sphincterotomy treaing (EST) common bile duct stones (<2.0cm in diameter) in 10 cases were reviewed to upgrade EST therapeutic efficacy. Of which 7 had single stone, 3 had multiple stones, 2 with Oddi sphincter inflammaory narrow.1 with chronic cholep-ancreatitis, 1 with acute obstructive suppurative choledochitis (AOSC), and Billroth II postagastrotomy were found in 2. The classen knife or self - designed needleknife was used after ERCP and the length cut-ted was 1. 0 ~2. 0cm. The results showed that EST successful rate 0f 8/10 (80 % ). It is esperienced that appropriate cutting is essential to treat common bile duct stone with EST. The needle knife should be used to make pecuuting followed by the standard knife while insufficient insertion of bow - knife. Front view -gastroscopy can be applied for the patients with Billroth II post - gastrotomy .

关 键 词：内镜 乳头括约肌 切开术 胆总管结石 针形切开刀 

分 类 号：R657.420.5[医药卫生—外科学]