巨大胆总管结石应用乳头括约肌小切开加大球囊扩张术的取石效果

发布时间：2019-04-13 15:25

【摘要】：目的:探讨巨大胆总管结石应用乳头括约肌小切开(SEST)加大球囊(15 mm~20mm)扩张术(EPLBD)的安全性及有效性。方法:对比分析2012年10月~20l4年05月在我们医院住院的胆总管结石直径在15mm~20mm之间的80例患者行乳头括约肌小切开加大球囊扩张术(SEST+EPLBD)与传统的乳头括约肌大切开加网篮碎石术的取石疗效差异与并发症。采用随机分组的方法将乳头括约肌小切开加大球囊扩张术作为观察组,传统的乳头括约肌大切开加网篮碎石术为对照组,并比较两组一期取石成功率、操作时间、X线照射时间、术后胰腺炎、术后出血穿孔感染等并发症情况。结果:观察组(43例)及对照组(37例)一期取石成功率分别为95.34%和94.59%,两组差异无显著性;操作时间分别为26.09±10.56和32.24±9.99,(P0.01),差异有显著性;X线照射时间分别为14.79±5.83和19.75±7.12min,P0.05,差异有显著性;术后早期并发症总发生率分别为4.6%(2/43)和11%(4/37),实验过程中无死亡事例报道。对照组并发症如出血和感染发生率明显高于观察组。结论:与传统的方法对比内镜下十二指肠乳头括约肌小切开术加大球囊扩张术(SEST+EPLBD)治疗巨大胆总管结石可缩短操作时间而且安全、有效。
[Abstract]:Aim: to evaluate the safety and efficacy of small incision of sphincter papillary sphincterotomy (SEST) plus balloon dilation (15 mm~20mm) in the treatment of giant bold common bile duct stones. Methods: 80 cases of choledocholithiasis in our hospital from Oct. 2012 to May 2014 were treated with small incision of papillary sphincter and balloon dilatation with (SEST EPLBD) and traditional sphincterotomy. Methods: from October 2012 to May 2014, 80 cases of choledocholithiasis in our hospital were treated with 15mm~20mm. The difference of curative effect and complication of open-mesh basket lithotripsy. The small incision and balloon dilation of sphincter papillae was used as the observation group, and the traditional large incision of sphincter papillae plus basket lithotripsy was used as the control group. The success rate and operation time of the first stage stone extraction were compared between the two groups. X-ray irradiation time, postoperative pancreatitis, postoperative bleeding and perforation infection and other complications. Results: the success rates of primary stone extraction in observation group (43 cases) and control group (37 cases) were 95.34% and 94.59%, respectively. There was no significant difference between the two groups. The operating time was 26.09 卤10.56 and 32.24 卤9.99 (P0.01), and the X-ray irradiation time was 14.79 卤5.83 and 19.75 卤7.12 min, P 0.05, respectively. The incidence of early postoperative complications was 4.6% (2 / 43) and 11% (4 / 37) respectively. No death cases were reported during the experiment. The incidence of complications such as bleeding and infection in control group was significantly higher than that in observation group. Conclusion: compared with the traditional method, endoscopic sphincterotomy plus balloon dilation (SEST EPLBD) can shorten the operation time and be safe and effective in the treatment of giant choledocholithiasis.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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