内镜下十二指肠乳头小切开联合球囊扩张在治疗胆总管结石中的应用价值

发布时间：2018-05-16 13:09

本文选题：胆总管结石 + 内镜　；参考：《青海大学》2015年硕士论文

【摘要】：目的探讨内镜下十二指肠乳头小切开联合球囊扩张在治疗胆总管大结石中的有效性、安全性及临床应用价值。方法对青海大学附属医院内镜中心及病案室提供的肝胆胰外科2004年1月至2014年11月行内镜下乳头括约肌切开术(EST)和内镜下乳头小切开联合球囊扩张(ESBD)取石的546例符合研究标准的胆总管结石患者的病例进行回顾性分析,统计并比较两组取石情况及近期并发症的发生率。结果行EST取石294例,行ESBD取石252例,两组中一期清除分别为262(89.1%)和224例(88.9%),差异无统计学意义(P0.05);碎石器使用例数分别为83例(28.2%)和34例(13.4%),差异有统计学意义(P0.05);两组平均操作时间分别为32.9±6.7min和21.4±2.6min,差异有统计学意义(P0.05)。早期并发症方面EST组发生急性胰腺炎7例,高淀粉酶血症19例,胆管炎9例,出血13例;ESBD组发生急性胰腺炎9例,高淀粉酶血症7例,胆管炎11例,出血2例,两组早期并发症总发生率分别为16.3%和11.5%,差异无统计学意义(P0.05)。结论 (1)ESBD是治疗胆总管结石的重要方式。(2)ESBD组和EST组在一期清除率,早期急性胰腺炎、胆管炎等并发症发生率方面相当,但在碎石器使用率、平均操作时间及早期高淀粉血症、出血方面ESBD优于EST。(3)ESBD是治疗胆总管大结石安全、有效的方法,值得在临床上广泛应用。
[Abstract]:Objective to evaluate the efficacy, safety and clinical value of endoscopic small incision of duodenal papilla combined with balloon dilation in the treatment of choledocholithiasis. Methods from January 2004 to November 2014, the endoscopic sphincterotomy (EST) and endoscopic mini-incision combined with balloon dilatation (ESBD) were performed in the Department of Hepatobiliary and Pancreatic surgery provided by the Endoscopic Center and the Medical record Room of the affiliated Hospital of Qinghai University. 546 patients were treated with endoscopic sphincterotomy and balloon dilatation (ESBD). Cases of choledocholithiasis in accordance with the study criteria were retrospectively analyzed. Statistics and comparison of the two groups of lithotomy and the incidence of recent complications. Results 294 cases were treated with EST and 252 cases with ESBD. There was no significant difference between the two groups (P 0.05) and 34 cases (P 0.05). The mean operating time of the two groups was 32.9 卤6.7min and 21.4 卤2.6 mins, respectively, and the difference was statistically significant (P 0.05). The mean operating time of the two groups was 32.9 卤6.7min and 21.4 卤2.6 mins respectively, and the difference was statistically significant (P0.05), and the difference was significant in 34 cases (P < 0.05), the mean operating time of the two groups was 32.9 卤6.7min and 21.4 卤2.6 mins, respectively, and the difference was statistically significant (P 0.05). There were 7 cases of acute pancreatitis, 19 cases of hyperamylase, 9 cases of cholangitis, 9 cases of acute pancreatitis, 7 cases of hyperamylase, 11 cases of cholangitis and 2 cases of hemorrhage in EST group. The total incidence of early complications in the two groups was 16.3% and 11.5%, respectively. There was no significant difference between the two groups (P 0.05). Conclusion ESBD is an important method in the treatment of choledocholithiasis. ESBD group and EST group have the same rate of primary clearance, early acute pancreatitis, cholangitis and other complications, but in the use of lithotriptor, the average operating time and early hyperamyloidemia. ESBD is superior to EST.(3)ESBD in the treatment of common bile duct stones.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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