EPLBD治疗胆总管结石的疗效分析  

作　　者：方宇韬 陈冻伢 沈红璋 张筱凤[2] 

机构地区：[1]杭州市红十字会医院,310003 [2]杭州市第一人民医院,310006

出　　处：《浙江临床医学》2023年第8期1195-1197,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省中医药科技计划项目(2022ZB263)。

摘　　要：目的探讨内镜下乳头大球囊扩张术(EPLBD)治疗胆总管结石的有效性、安全性。方法回顾性分析杭州市第一人民医院2016年1月至2020年12月期间因胆总管结石行EPLBD患者,根据是否联合乳头括约肌切开(EST)分为单纯EPLBD组(162例)和EST联合EPLBD组(222例),比较两组的治疗效果、术后近期并发症发生率。结果单纯组和联合组总体成功率、一次取净率和手术时间分别为97.5%VS.97.7%、79.61%VS.76.17%、21.4(18.1)min VS.24.1(16.55)min,差异无统计学意义(P>0.05),联合组可降低机械碎石率(18.3%VS.8.2%,P=0.019)。两组并发出血发生率、胰腺炎发生率和术后尿淀粉酶水平分别4.6%VS.6.8%、2.5%VS.2.3%;197(392)U/L VS.242(385.5)U/L,差异无统计学意义(P>0.05)。结论EPLBD术治疗胆总管结石安全有效,联合EST可减少机械碎石使用率。Objective To investigate the efficacy and safety of endoscopic papillary balloon dilation(EPLBD)for treatment for common bile duct stones.Methods Data of 162 patients who received EPLBD and 222 patients who received EST+EPLBD from January 2016 to December 2020 in our hospital were collected.The efficacy and adverse events of two group were compared.Results There was no significant difference in the overall success rate(97.5%,97.7%),initial success rate(79.61%,76.17%)and procedure time[21.4(18.1)min;24.1(16.55)min]between EPLBD and EST+EPLBD.The use of mechanical lithotripsy is more frequent in EPLBD(18.3%VS.8.2%,P=0.019).There was no significant difference in pancreatitis(2.5%,2.3%),bleeding(4.6%,6.8%)and urinary amylase levels[197(392)U/L;242(385.5)U/L].Conclusion EPLBD is safe and feasible for the treatment of common bile duct stones,while EST+EPLBD can decrease the use rate of mechanical lithotripsy.

关 键 词：内镜下乳头大球囊扩张术 内镜下乳头括约肌切开术 胆总管结石 机械碎石 并发症 

分 类 号：R657.4[医药卫生—外科学]