一种新型网篮在无射线内镜胆总管结石取石术中的应用研究(含视频)  

Evaluation of a newly designed basket in non-radiation endoscopic lithotomy for common bile duct stones (with video)

作　　者：冯亚东[1] 李媛媛[1] 梁燕[1] 刘洋[1] 张有玉 张炯 张胤秋 施瑞华[1] Feng Yadong;Li Yuanyuan;Liang Yan;Liu Yang;Youyu Zhag;Zhang Jiong;Zhang Yinqiu;Shi Ruihua(Department of Gastroenterology,Zhongda Hospital Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院消化科,南京210009

出　　处：《中华消化内镜杂志》2023年第3期201-205,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的评价一种适用于胆道子镜的新型取石网篮在无射线内镜胆总管结石取石术中的应用价值。方法纳入2021年2—10月在东南大学附属中大医院接受无射线胆道镜下胆总管结石取石术的78例患者进行随机对照研究,按照抽签法随机分为新型网篮取石组(35例)及普通网篮取石组(43例),分析并比较2组之间胆道镜探查次数、网篮取石次数、术中注水量、取石及胆道镜探查时间、总体内镜操作时间以及术后不良事件。结果与普通网篮取石组比较,新型网篮取石组胆道镜探查次数较少[(1.08±0.28)次比(2.30±0.51)次,t=-12.535,P<0.001],术中注水量较少[(46.14±11.89)mL比(78.62±10.09)mL,t=-13.052,P<0.001],取石及胆道镜探查时间较短[(9.69±2.97)min比(12.67±2.51)min,t=-4.815,P<0.001],总体内镜操作时间也较短[(30.17±7.19)min比(33.44±6.69)min,t=-2.076,P=0.041]。2组之间不良事件发生率差异无统计学意义[5.7%(2/35)比11.6%(5/43),χ^(2)=0.826,P=0.363]。结论新型取石网篮胆总管取石操作时间短,胆道镜探查次数少,术中注水量少,能够方便胆道镜直视下的无射线取石。Objective To evaluate a newly designed basket fit for digital cholangioscope in non-radiation endoscopic lithotomy for common bile duct stones.Methods Seventy-eight patients who underwent non-radiation endoscopic removal of common bile duct stones at Zhongda Hospital Southeast University between February and October 2021 were enrolled in the randomized controlled trial,and were randomly assigned into the new basket group(n=35)and the conventional basket group(n=43)by drawing lots.Procedures of cholangioscope-based biliary exploration and stone removal by baskets,volume of water irrigation,time lengths of biliary exploration,stone removal and whole endoscopic procedure,and adverse events were compared.Results Compared with the conventional basket group,the new basket group needed less biliary explorations(1.08±0.28 VS 2.30±0.51,t=-12.535,P<0.001),smaller volume of water irrigation(46.14±11.89 mL VS 78.62±10.09 mL,t=-13.052,P<0.001),and shorter time of biliary exploration and stone removal(9.69±2.97 min VS 12.67±2.51 min,t=-4.815,P<0.001)and whole endoscopic procedure(30.17±7.19 min VS 33.44±6.69 min,t=-2.076,P=0.041).The incidence of adverse events was not significantly different between the two groups[5.7%(2/35)VS 11.6%(5/43),χ^(2)=0.826,P=0.363].Conclusion This newly designed basket can facilitate digital cholangioscope-guided non-radiation endoscopic removal of common bile duct stones with the advantages of shorter operation time,less exploration time of choledochoscopy and smaller volume of water irrigation.

关 键 词：胆总管结石病 新型取石网篮 数字胆道镜 无射线取石术 

分 类 号：R657.4[医药卫生—外科学]