EST小切开联合EPBD治疗乳头旁憩室合并胆总管结石的疗效分析  

Limited endoscopic sphincterotomy plus balloon dilatation treatment common bile duct stonescombinedjuxtapapillary diverticulum

作　　者：向正国[1] 李科军[1] 陈旭峰[1] 郑扬[1] 杨胜兰[1] 汤小龙[1] 

机构地区：[1]解放军101医院消化内科,江苏无锡214044

出　　处：《东南国防医药》2013年第3期238-240,共3页Military Medical Journal of Southeast China

摘　　要：目的探讨内镜下乳头括约肌小切开联合气囊扩张术治疗乳头旁憩室合并胆总管结石的效果和安全性。方法回顾175例十二指肠乳头旁憩室合并胆总管结石的治疗,85例采用乳头括约肌小切开联合气囊扩张术取石,作为观察组,90例行常规内镜下乳头括约肌切开取石作为对照组,观察取石成功率、术中碎石率和术后并发症。结果观察组取石成功率为96.5%,对照组93.3%,两组比较差异无统计学意义(P>0.05)。而碎石率分别为14.1%和31.1%,观察组明显少于对照组。观察组无出血,明显少于对照组的6.7%。术后胰腺炎、高淀粉酶血症和胆管炎两组相当,差异无统计学意义(P>0.05)。结论内镜下乳头括约肌小切开联合气囊扩张术治疗乳头旁憩室合并胆总管结石可以减少术中碎石率和出血率,是一种安全、有效的治疗方法。Objective To evaluate the therapeutic efficacy and safety of limited endoscopic sphincterotomy plus balloon dila- tation in the treatment of the common bile duct stones combined juxtapapillary diverticulum. Methods Respecting the treatment of 175 cases with duodenal diverticula combained biliary stones. 85 patients as observation group were treated with limited EST plus EPBD, and 90 patients conventional EST treatment as control. Rates of stone success, mechanical brokenstone and complications were observed. Re- suits Rate of stone success in treatment group was 96.5 %, control group was 93.3 %. There was no significance （P 〉 0.05 ）. The rates of mechanical brokenstone were 14.1% and 31.1% in two groups. The rate in observation group was less than that in control group. Observation group was no bleeding and less than 6.7% in control group. Rates of two groups were similar in postoperrative pancreatitis, hyperamylasemia and cholangitis（P 〉 0.05）. Conclusion Limited endoscopic sphincterotomy plus balloon dilatation treatment com- mon bile duct stones combined juxtapapillary diverticulum can reduce the bleeding rate and mechanical brokenstone rate. It is a safe and effective treatment.

关 键 词：十二指肠乳头旁憩室 胆总管结石 乳头括约肌小切开 乳头气囊扩张术 

分 类 号：R573[医药卫生—消化系统]