高龄患者胆总管巨大结石的内镜治疗  

Endoscopic therapy of large common bile duct stones in elderly patients

作　　者：金燕[1] 孙源源[1] 张振中[1] 陈伍霞[1] 

机构地区：[1]南通大学附属南通第三医院消化内科,江苏南通226006

出　　处：《胃肠病学和肝病学杂志》2010年第11期1054-1056,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨内镜对高龄患者胆总管巨大结石的可行性和疗效。方法 29例高龄胆总管巨大结石患者完善术前准备,在密切监护下经十二指肠镜先行内镜下逆行胰胆管造影术(ERCP),胆总管显影发现结石,均给予内镜下括约肌切开术(EST)和机械碎石术(EML)取石。根据具体情况,留置鼻胆管引流。结果 28例取石成功,取石成功率96.6%,有11例行鼻胆管引流。乳头肌切口创面轻度渗血3例,一过性高淀粉酶血症8例,未发生严重并发症和死亡。结论 EST联合EML治疗高龄患者胆总管巨大结石安全有效,但娴熟的内镜操作技术、精心的术前准备及术中的仔细监护和处理是保证操作成功的重要条件。Objective To study the feasibility and effect of endoscopic therapy of large common bile duct stones in elderly patients. Methods Twenty-nine elderly patients with large common bile duct stones consummated preoperotive preparation,then underwent endoscopic retrograde cholangiopancreatography （ ERCP） through duodenoscopy in close monitoring. All patiens were treated with endoscopic sphincterotomy （ EST） and endoscopic mechanical hthotripsy （ EML） after common bile duct stones visualization. Endoscopic nasobiliary drainage was given according the specific circumstances. Results Bile stones of 28 cases were obtained,the success rate was 96. 6% . Eleven patients made nasobiliary drainage. Only 3 cases suffered staxis of mild sphincter incision and 8 cases suffered transient hyperamylasemia. No serous complication and death were abserved. Conclusion EST associated with EML are safe and effective in the treatment of large common bile duct stones in elderly patients. Skillful endoscopic operation,careful preoperotive preparation and intraoperative close monitoring are the keys for the successful operation.

关 键 词：胆总管巨大结石 高龄 内镜治疗 

分 类 号：R575.62[医药卫生—消化系统]