SpyGlass DS系统联合内镜逆行胰胆管造影术对胆总管结石患者的治疗作用  

Therapeutic effects of SpyGlass DS system combined with endoscopic retrograde cholangiopancreatography(ERCP)on patients with choledocholithiasis

作　　者：韩卓兴 林晖 段世刚 叶志荣 陈炫廷 林康强 HAN Zhuoxing;LIN Hui;DUAN Shigang;YE Zhirong;CHEN Xuanting;LIN Kangqiang(Department of Hepatobiliary and Pancreatic Surgery,The Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,Guangdong,China)

机构地区：[1]广东医科大学附属第二医院肝胆胰外科,广东湛江524000

出　　处：《山东大学学报（医学版）》2023年第9期94-100,共7页Journal of Shandong University:Health Sciences

基　　金：湛江市科技计划(2021A05111)。

摘　　要：目的探究SpyGlass DS系统联合内镜逆行胰胆管造影术(ERCP)对胆总管结石患者治疗的影响。方法收集接受SpyGlass DS系统联合ERCP手术患者(n=23,试验组)和单纯接受ERCP手术患者(n=51,对照组),分析手术前后两组患者手术指标和结局、Oddi括约肌基础压、收缩压高峰值和收缩频率,以及血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)和总胆红素(TBil)表达水平差异。结果与对照组相比,试验组手术时间更长,住院费用更高,住院时间更短(P<0.05),试验组一次结石清除率高于对照组(95.65%vs 72.55%,P<0.05),术后胰腺炎发生率低于对照组(8.70%vs 21.57%,P>0.05),术后试验组和对照组括约肌和肝胆功能表达水平均降低,试验组括约肌的基础压、收缩压高峰值、收缩频率高于对照组(P<0.05),ALT、AST和TBil表达水平与对照组差异无统计学意义(P>0.05)。结论SpyGlass DS系统在ERCP取石手术中适用效果更好,可能作为一种有效的胆总管结石治疗手术方式应用于临床实践。Objective To investigate the effects of SpyGlass DS system combined with endoscopic retrograde cholangiopancreatography(ERCP)on patients with choledocholithiasis.Methods Clinical data of patients who received SpyGlass DS combined with ERCP(n=23,experimental group)and patients who received ERCP only(n=51,control group)were collected.The operation indicators and outcomes,Oddi sphincter base pressure,peak systolic blood pressure and systolic frequency,as well as differences in the expression levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)were analyzed.Results Compared with the control group,the experimental group had longer operation time,higher hospitalization expenses,shorter hospital stay(P<0.05),higher stone clearance rate(95.65%vs 72.55%,P<0.05),and lower incidence of postoperative pancreatitis(8.70%vs 21.57%,P>0.05).The indicators of sphincter and hepatobiliary function in experimental group and control group were decreased after surgery,and the sphincter base pressure,peak systolic blood pressure and systolic frequency of experimental group were higher than those of control group(P<0.05).There were no significant differences in the expression levels of ALT,AST and TBil between the two groups(P>0.05).Conclusion SpyGlass DS system has a good application effect in ERCP lithotomy.It may be used in clinical practice as an effective surgical method for the treatment of choledocholithiasis.

关 键 词：SpyGlass DS系统 内镜逆行胰胆管造影术 胆总管结石 ODDI括约肌功能 

分 类 号：R576[医药卫生—消化系统]