内镜下胆管塑料支架内引流治疗难取性胆总管结石  

Treatment for difficult common bile duct stones by endoscopic retrograde biliary plastic stent placement drainage

作　　者：邹传鑫[1] 谢明[1] 王朝霞[1] 戴绍军[1] 陈海燕[1] 姚永刚[1] 范志宁[2] 

机构地区：[1]湖北省荆州市中心医院消化内科,湖北荆州434020 [2]南京医科大学第二附属医院消化医学中心,江苏南京210011

出　　处：《中国内镜杂志》2011年第6期619-621,共3页China Journal of Endoscopy

摘　　要：目的探讨塑料支架内引流(ERBD)术治疗难取性胆总管结石的疗效。方法采用常规方法行经内镜逆行胰胆管造影(ERCP)造影,对48例胆总管难取性结石患者在导丝引导下置入8.5F塑料胆管内支架1、2根,并随访6～18个月。结果 6个月后B超复查时发现38例患者结石直径变小或成碎片状,第2次ERCP经网篮或气囊顺利取出;10例结石无明显变化,B超随访,一旦发现结石明显变小,即再次ERCP+取石;经平均2.5次内镜下治疗,95.8%(46/48)患者结石取净。期间未发生与ERCP或留置支架相关的严重并发症。结论留置塑料内支架是治疗难取性胆总管结石简单有效的方法。[Objective] To evaluate the efficacy of plastic stents in the management of difficult common bile duct（CBD） stones.[Methods] 48 patents with difficulty to extract CBD stones after ERCP were included in this study.One or two 8.5F plastic stent was instered into the CBD of all the subjects,respectively,over a guidewire by the standard way.They were followed up from 6 to 18 months.[Results] In 38 patients,B ultrasonography revealed that the stones became smaller than before or became stone fragments after stent placement 6 months later in the CBD,the stones were easily extracted by using balloons or baskets through the second ERCP.10 patients continued to have large stones,they were followed up through B ultrasonography,and further endoscopic treatments were performed immediately when the stones became smaller.enough.46/48 Difficult CBD stones were eventually cleared through average 2.5 times endoscopic treatment.There was no severe complications related to ERCP or stent placement.[Conclusion] Placement of plastic biliary stents is a simple and effective measure in the treatment of difficult CBD stones.

关 键 词：内镜下胆管塑料支架引流术 难取性胆总管结石 胆管塑料支架 内镜下乳头括约肌切开术 

分 类 号：R657.42[医药卫生—外科学]