内镜下乳头括约肌球囊扩张术治疗胆总管结石的安全性和有效性分析  

Safety and efficacy of endoscopic papillary balloon dilation in the treatment of common bile duct stones

作　　者：高悦悦 陶凯歌 朱美玲 刘加宁 李运红 Gao Yueyue;Tao Kaige;Zhu Meiling;Liu Jianing;Li Yunhong(Department of Gastroenterology,Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,Jiangsu,China)

机构地区：[1]徐州医科大学附属宿迁医院消化内科,江苏宿迁223800

出　　处：《兰州大学学报（医学版）》2024年第5期49-55,共7页Journal of Lanzhou University（Medical Sciences）

基　　金：宿迁市社会发展基金资助项目(S201719)。

摘　　要：目的评价内镜下乳头括约肌球囊扩张术治疗胆总管结石的安全性和有效性。方法回顾性选取2015年1月—2022年10月在徐州医科大学附属宿迁医院接受内镜治疗胆总管结石的284例患者,术中的球囊扩张时间均为5 min,依手术方式分为内镜下乳头括约肌切开术(37例)、内镜下乳头括约肌球囊扩张术(49例)及内镜下乳头括约肌小切开联合球囊扩张术(198例)3组,收集患者的人口学特征、临床特征及短期并发症等资料并分析安全性和有效性。结果安全性方面,内镜下乳头括约肌球囊扩张术组术中出血发生率(6.1%)明显低于内镜下乳头括约肌切开术组(29.7%)以及内镜下乳头括约肌小切开联合球囊扩张术(26.3%)组,差异有统计学意义(P=0.003)。3组患者间的其他短期并发症发生率差异无统计学意义。有效性方面,3组患者的首次结石清除率和机械碎石率差异无统计学意义。结论内镜下乳头括约肌球囊扩张术手术安全有效,且术中出血风险更低,临床应用具有价值。Objective To evaluate the safety and efficacy of endoscopic papillary balloon dilation(EPBD)in the treatment of common bile duct stones.Methods A total of 284 patients who received endoscopic treatment for common bile duct stones in Affiliated Suqian Hospital of Xuzhou Medical University from January 2015 to October 2022 were selected as the study objects and divided into three groups,namely endoscopic sphincterotomy(EST)(37),EPBD(49)and EST+EPBD(198),according to endoscopic methods.The demographic characteristics,clinical characteristics and short-term complication rate of these patients were retrospectively collected.The safety and efficacy of them were analyzed.Results In terms of safety,the incidence of intraoperative bleeding in the EPBD group(6.1%)was significantly lower compared to that in the EST group(29.7%)and the EST+EPBD group(26.3%),demonstrating statistical significance(P=0.003).There were no statistical differences observed among the three groups.Regarding effectiveness,there were no significant differences found in both the first stone clearance rate and mechanical lithotripsy rate among the three groups.Conclusion EPBD surgery is safe and effective,and the risk of intraoperative bleeding is lower,thus worthy of clinical application.

关 键 词：内镜下乳头括约肌切开术 内镜下乳头括约肌球囊扩张术 胆总管结石 内镜逆行胰胆管造影 

分 类 号：R575.7[医药卫生—消化系统]