内镜下乳头修补术对Oddi括约肌切开胆总管取石术后复发的影响  

Effect of endoscopic nipple repair on recurrence after Oddi sphincterotomy and choledocholithotomy

作　　者：肖志强 黄恋君 周巧容 王跃平 XIAO Zhiqiang;HUANG Lianjun;ZHOU Qiaorong;WANG Yueping(Department of Gastroenterology,the First Affiliated Hospital of Shaoyang University,Hunan Province,Shaoyang 422000,China)

机构地区：[1]邵阳学院附属第一医院消化内科,湖南邵阳422000

出　　处：《中国当代医药》2023年第26期93-96,共4页China Modern Medicine

基　　金：湖南省教育厅科学研究项目(21C0612)。

摘　　要：目的研究内镜下乳头修补术对内镜下十二指肠乳头Oddi括约肌切开胆总管取石术后胆总管结石复发的影响。方法回顾性选取2020年2月至7月邵阳学院附属第一医院消化内科收治的51例因胆总管结石行内镜下十二指肠乳头Oddi括约肌切开取石术患者作为研究对象,按照是否行内镜下乳头修补术分为乳头修补组(17例)及对照组(34例)。乳头修补组在乳头Oddi括约肌切开取石后行内镜下钛夹修补切开的Oddi括约肌,对照组采用常规的乳头Oddi括约肌切开取石术。比较两组患者的术后短期并发症(术后出血、穿孔、胰腺炎、胆管炎、高淀粉酶血症等情况)及长期并发症(2年结石复发情况)。结果两组患者的短期并发症、长期并发症发生率及碎石率比较,差异无统计学意义(P>0.05)。结论内镜下钛夹乳头修补术没有增加并发症的发生,但未能显著降低术后胆总管结石的复发率。Objective To study the effect of endoscopic nipple repair surgery on the recurrence of common bile duct stones after endoscopic Oddi sphincterotomy of the duodenal papilla.Methods A total of 51 patients admitted to the Department of Gastroenterology at the First Affiliated Hospital of Shaoyang University from February to July 2020 who underwent endoscopic duodenal papillary Oddi sphincterotomy for common bile duct stones were retrospectively selected as study objects,they were divided into nipple repair group(17 cases)and control group(34 cases)based on whether endoscopic papillary repair was performed.The nipple repair group underwent endoscopic titanium clip repair of the Oddi sphincter after incision and stone removal,while the control group underwent routine nipple Oddi sphincter incision and stone removal.The short-term postoperative complications(postoperative bleeding,perforation,pancreatitis,cholangitis,hyperamylasemia,etc.)and long-term complications(2-year stone recurrence)of the two groups of patients were compared.Results There were no statistically significant differences in the incidence of short-term complications,long-term complications and lithotripsy between the two groups of patients(P>0.05).Conclusion Endoscopic titanium clip nipple repair did not increase the incidence of complications,but did not significantly reduce the recurrence rate of postoperative common bile duct stones.

关 键 词：乳头修补 内镜 内镜逆行胆胰管造影 胆总管结石 

分 类 号：R364.25[医药卫生—病理学]