|本期目录/Table of Contents|

[1]向正国,李科军,陈旭峰,等.EST小切开联合EPBD治疗乳头旁憩室合并胆总管结石的疗效分析[J].医学研究与战创伤救治(原医学研究生学报),2013,15(03):238-240.[doi:10.3969/j.issn.1672-271X.2013.03.010]
　XIANG Zheng-guo,LI Ke-jun,CHEN Xu-feng,et al.Limited endoscopic sphincterotomy plus balloon dilatation treatment common bile duct stonescombinedjuxtapapillary diverticulum[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2013,15(03):238-240.[doi:10.3969/j.issn.1672-271X.2013.03.010]
点击复制

EST小切开联合EPBD治疗乳头旁憩室合并胆总管结石的疗效分析()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第15卷
期数:
2013年03期
页码:
238-240
栏目:
出版日期:
2013-03-30

文章信息/Info

Title:
Limited endoscopic sphincterotomy plus balloon dilatation treatment common bile duct stonescombinedjuxtapapillary diverticulum
作者:
向正国; 李科军; 陈旭峰; 郑 扬; 杨胜兰; 汤小龙
214044 江苏无锡,解放军101医院消化内科
Author(s):
XIANG Zheng-guo; LI Ke-jun; CHEN Xu-feng; ZHEN Yang; YANG Sheng-lan; TANG Xiao-long
Department of Gastroenterology,101 Hospital of PLA,Wuxi,Jiangsu 214044,China
关键词:
十二指肠乳头旁憩室; 胆总管结石; 乳头括约肌小切开; 乳头气囊扩张术
Keywords:
juxtapapillary diverticula;  common bile duct stones;  limited endoscopic sphincterotomy;  endoscopic papillary balloon dilatation
分类号:
R573
DOI:
10.3969/j.issn.1672-271X.2013.03.010
文献标志码:
A
摘要:
目的 探讨内镜下乳头括约肌小切开联合气囊扩张术治疗乳头旁憩室合并胆总管结石的效果和安全性。方法 回顾175例十二指肠乳头旁憩室合并胆总管结石的治疗,85例采用乳头括约肌小切开联合气囊扩张术取石,作为观察组,90例行常规内镜下乳头括约肌切开取石作为对照组,观察取石成功率、术中碎石率和术后并发症。结果 观察组取石成功率为96.5%,对照组93.3%,两组比较差异无统计学意义(P>0.05)。而碎石率分别为14.1%和31.1%,观察组明显少于对照组。观察组无出血,明显少于对照组的6.7%。术后胰腺炎、高淀粉酶血症和胆管炎两组相当,差异无统计学意义(P>0.05)。结论 内镜下乳头括约肌小切开联合气囊扩张术治疗乳头旁憩室合并胆总管结石可以减少术中碎石率和出血率,是一种安全、有效的治疗方法。
Abstract:
Objective To evaluate the therapeutic efficacy and safety of limited endoscopic sphincterotomy plus balloon dilatation in the treatment of the common bile duct stones combined juxtapapillary diverticulum.Methods Respecting the treatment of 175 cases with duodenal diverticula combained biliary stones.85 patients as observation group were treated with limited EST plus EPBD,and 90 patients conventional EST treatment as control.Rates of stone success,mechanical brokenstone and complications were observed.Results Rate of stone success in treatment group was 96.5%,control group was 93.3%.There was no significance(P>0.05).The rates of mechanical brokenstone were 14.1% and 31.1% in two groups.The rate in observation group was less than that in control group.Observation group was no bleeding and less than 6.7% in control group.Rates of two groups were similar in postoperrative pancreatitis,hyperamylasemia and cholangitis(P>0.05).Conclusion Limited endoscopic sphincterotomy plus balloon dilatation treatment common bile duct stones combined juxtapapillary diverticulum can reduce the bleeding rate and mechanical brokenstone rate.It is a safe and effective treatment.

参考文献/References:

[1] Li ZS,Xu GM,Sun ZX,et al.The dealing with the early complications of the diagnostic and therapeutic ERCP[J].Chin J Dig Endosc,2002,19(2):77-80. [2] Cotton PB,Lehman G,Vennes J,et al.Endoscopic sphincterotomy complications and their management:an attempt at consensus[J].Gastrointest Endosc,1991,37(3):383-393. [3] 龚 彪.改良内镜下乳头气囊扩张术应用的可行性研究[J].中华消化内镜杂志,2006,23(6):407-409. [4] Aiura K, Kitagawa Y.Current status of endoscopic papillary balloon dilation for the treatment of bile duct stones[J].J Hepatobiliary Pancreat Sci,2011,18(3):339-345. [5] Baron TH,Harewood GC.Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP:a meta-analysis of randomized controlled trials[J].Am J Gastroenterol,2004,99(8):1455-1460. [6] 郝立校,王 坚,焦成文.内镜下乳头气囊扩张术后并发胰腺损伤的高危因素分析[J].中国内镜杂志,2012,18(3):233-236. [7] Itoi T,Itokawa F,Sofuni A,et al.Endoscopic sphincterotomy combined with large balloon dilation can reduce the procedure time and fluoroscopy time for removal of large bile duct stones[J].Am J Gastroenterol,2009,104(3):560-565. [8] 张 宁,麻树人,杨 卓.乳头括约肌小切开合并气囊扩张术治疗胆总管结石532例分析[J].中国实用内科杂志,2010,30(3):263-264. [9] 苏进根,王建平,陈跃宇.乳头括约肌小切开加大径气囊扩张术治疗胆总管结石的价值[J].肝胆外科杂志,2012,20(5):340-342. [10] Attam R,Freeman ML.Endoscopic papillary large balloon dilation for large common bile duct stones[J].J Hepatobiliary Pancreat Surg,2009,16(5):618-623. [11] 王 坚,郝立校,焦成文.胆管内用药预防内镜下胰胆管逆行造影所致急性胰腺炎[J].东南国防医药,2009,11(1):17-19. [12] 单深良,梁华钦,欧 希.内镜下乳头气囊扩张术在胆总管结石治疗中的应用[J].医学综述,2012,18(17):2863-2865.

相似文献/References:

[1]胡维杰,吴万桂,李欣,等.内镜下切开十二指肠乳头括约肌治疗胆总管结石135例临床分析[J].医学研究与战创伤救治(原医学研究生学报),2013,15(02):138.
　Department of Gastroenterology,8 Hospital of PLA,Nanjing,et al.HU Wei-jie,WU Wan-gui,LI Xin,WANG Xiao-jun[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2013,15(03):138.
[2]蒋辉,詹刚,周骏,等.两种微创术式治疗胆囊切除术后胆总管结石的疗效影响[J].医学研究与战创伤救治(原医学研究生学报),2023,25(1):1.[doi:10.3969/j.issn.1672-271X.2023.01.001]
　JIANG Hui,ZHAN Gang,ZHOU Jun,et al.Efficacy of ERCP and LCBDE in the treatment of common bile duct stones after cholecystectomy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2023,25(03):1.[doi:10.3969/j.issn.1672-271X.2023.01.001]

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2013-05-20