十二指肠乳头括约肌切开术对胆囊动力功能的影响  

Effect of endoscopic sphincterotomy on function of gall bladder motility

作　　者：杨建锋[1] 王霞[1] 王晖[1] 张啸[1] 张筱凤[1] 方建华[2] 

机构地区：[1]杭州市第一人民医院消化科,310006 [2]杭州市第一人民医院超声影像科,310006

出　　处：《中华消化内镜杂志》2013年第11期614-617,共4页Chinese Journal of Digestive Endoscopy

基　　金：浙江省医药卫生科技计划（2010KBY083）

摘　　要：目的探讨十二指肠乳头括约肌切开术（EST）对胆囊动力功能的近期和远期影响。方法收集2010年1月至2012年6月行ERCP取石的胆总管结石患者60例，患者均有完整的胆囊，按是否合并胆囊结石，分为合并胆囊结石与不合并胆囊结石两组，每组30例。分别采用彩色B超实时监控，对比EST前、后胆囊空腹及经脂肪餐刺激后胆囊容积的变化。随访观察EST术后胆囊炎的发病率。结果与EST术前相比，2组患者EST术后空腹胆囊体积和剩余胆囊体积均明显缩小，胆囊收缩率也显著升高。平均随访18．7个月，合并胆囊结石组患者EST术后胆囊炎发作率与不合并胆囊结石组相似，但胆总管结石复发率明显增高（26．7％比6．7％，P=0．032）。结论EST术后胆囊的收缩能力增强，胆囊结石患者术后虽胆囊炎发生率并无增加，但有较高的继发胆总管结石发生率。Objective To investigate the effect of endoscopic sphincterotomy （EST） on function of gall bladder motility. Methods Sixty patients with common bile duct stones and intact gallbladder were re- cruited from January 2010 to June 2012 and divided to two groups according to with or without cholecystolithi- asis. All patients underwent real-time ultrasound examination to assess bladder motility at fasting and after fat meal, and were followed up to observe the incidence of cholecystitis after EST. Results Compared with those before EST, there was a significant reduction in mean fasting volume and mean residual volume of gall- bladder, and an increase in gall bladder emptying after EST. Within the mean follow-up period of 18.7 months, the incidence of eholecystitis in patients with cholecystolithiasis was similar with that of patients without cholecystolithiasis, but the recurrent rate of common duct stone was higher （26.7% vs. 6. 7%, P = 0. 032）. Conclusion After EST, contractility of the gall bladder is enhanced, although the rate of chole- cystitis is similar to patients without cholecystolithiasis, the incidence of secondary common bile duet stone in patients with choleeystolithiasis increases.

关 键 词：括约肌切开术 内窥镜 胆总管结石 胆囊结石病 

分 类 号：R657.4[医药卫生—外科学]