内镜下不同大小气囊十二指肠乳头扩张术治疗胆总管结石的近期疗效

发布时间：2018-09-13 13:23

【摘要】：目的探讨内镜下不同直径大小气囊十二指肠乳头扩张术(EPBD)治疗胆总管结石的近期疗效。方法将上海市浦东新区公利医院普外科2015年1月-2015年10月连续收治的80例胆总管结石患者作为研究对象,根据胆总管结石大小分别采用直径8、10、12和14 mm的气囊扩张,相应将胆总管结石患者分成4组,分别为8 mm组、10 mm组、12 mm组和14 mm组。然后采用取石网篮取石、取石球囊取石,必要时行机械碎石。观察各组患者术后24 h出血、急性胰腺炎、高淀粉酶血症和肠穿孔的发生情况;术后2周行上腹部CT、胃肠造影检查,观察各组患者胆道积气、胆总管返流发生情况,分析比较不同组之间的近期疗效。结果各组患者均在EPBD下取石成功,取石成功率100.0%,各组间出血、穿孔、急性胰腺炎和高淀粉酶血症差异无统计学意义(P0.05);而在术后2周胆道积气和胆总管返流差异具有统计学意义(P0.05)。结论 EPBD是一种安全有效的胆总管取石方法,随气囊直径增加,对Oddi括约肌功能影响可能越大。
[Abstract]:Objective to evaluate the short-term efficacy of endoscopic balloon-duodenal papilla dilatation (EPBD) in the treatment of choledocholithiasis. Methods Eighty consecutive patients with choledocholithiasis from January 2015 to October 2015 in General surgery Department of Gongli Hospital, Pudong District, Shanghai, were selected as study subjects. According to the size of choledocholithiasis, balloon dilatation was performed at the diameter of 810 mm and 14 mm, respectively. The patients with choledocholithiasis were divided into 4 groups: 8 mm group, 10 mm group, 12 mm group and 14 mm group. Then the stone basket is used to take the stone, the stone balloon is used to take the stone, and the mechanical gravel is used when necessary. The incidence of hemorrhage, acute pancreatitis, hyperamylase and intestinal perforation were observed 24 hours after operation, and the upper abdominal CT, gastrography was performed 2 weeks after operation to observe the occurrence of bile duct gas accumulation and common bile duct regurgitation. The short-term efficacy of different groups was analyzed and compared. Results all the patients were successfully removed under EPBD, and the success rate of lithotomy was 100.0. There was no significant difference in bleeding, perforation, acute pancreatitis and hyperamylase in each group (P0.05), but there was significant difference in bile duct accumulation and bile duct regurgitation 2 weeks after operation (P0.05). Conclusion EPBD is a safe and effective method for choledocholithiasis extraction. The greater the diameter of balloon, the greater the effect on the sphincter function of Oddi.
【作者单位】：宁夏医科大学;上海市浦东新区公利医院普外科;上海市交通大学附属瑞金医院北院普外科;
【基金】：上海市浦东新区科技发展基金创新资金资助(No:PKJ2013-Y06)
【分类号】：R657.42

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