ERCP联合ESWL治疗胰管结石12例报道(英文)  

Treatment of pancreatic duct stones with extracorporeal shock wave lithotripsy( ESWL) combined with endoscopic retrograde cholangiopancreatography( ERCP) :a report of 12 cases

作　　者：张景涛[1] 桂亚平[2] 陈泉宁[1] 刘黎明[1] 范跃祖[1] 鲁星燧[1] 

机构地区：[1]同济大学附属同济医院外科,上海200065 [2]同济大学附属同济医院泌尿科,上海200065

出　　处：《外科研究与新技术》2014年第1期17-21,共5页Surgical Research and New Technique

摘　　要：目的 评价ERCP联合ESWL治疗胰管结石的效果.方法 2008年1月-2009年12月在我院经影像学确诊的12例胰管结石患者接受了ERCP联合ESWL治疗.先行ERCP以了解胰管形态改变并放置胰管支架;续行ESWL,依结石形态及密度了解碎石效果,对碎石不满意者重复ESWL;6-8周后再行ERCP取石.结果 所有患者全部碎石成功（根据结石密度和体积变化）;其中,1例行ESWL后结石完全排净,5例ESWL后经内镜治疗结石被完全清除,1例结石部分清除,1例取石失败,2例碎石后失访.治疗期间未出现严重并发症.结论 ESWL对胰管结石碎石效果好,但单纯ESWL仅部分患者结石可自行排出;ESWL后结合内镜取石治疗,能提高胰管结石清除效果.Objective To evaluate the efficacy of ESWL combined with ERCP for the treatment of pancreatic duct stones （PDSs）. Methods 12 patients with PDSs confirmed by ultrasound and radiography received treatment in our hospital from January 2008 to March 2010. ERCP was first performed to determine the ductal morphology, the location and number of stones, which pancreatic sphincterotomy and stenting were performed depending on the condition of the patients. ESWL was performed in all patients and repeated depending on stone changes. 6 - 8 weeks after ESWL, therapeutic ERCP for balloon dilation and stone extraction was performed to manage residual stones. Pancreatic stents were placed after stone extraction. Results ESWL was performed and stone fragmentation was achieved in all patients. Spontaneous stone clearance after ESWL alone occurred in one patient. Complete duct clearance was achieved in 7 patients by therapeutic ERCP; partial duct clearance was achieved in one patient; and duct clearance failed in one patients. Of the 12 patients, two patients failed to follow-up after ESWL. No procedure-related major complication occurred. Conclusions ESWL is effective for PDS fragmentation and can be repeated. A high rate of successful PDS clearance can be achieved when therapeutic ERCP is followed by ESWL.

关 键 词：胰管结石 体外冲击波碎石 逆行胰胆管造影 

分 类 号：R657.5[医药卫生—外科学]