内镜下乳头括约肌小切开联合气囊扩张术对胆总管结石患者的疗效观察

目的 观察乳头括约肌小切开联合气囊扩张术对胆总管结石( CDS)患者的疗效.方法 将我院2010年1月至2011年9月间的161例CDS患者分为3组,54例行内镜下乳头括约肌切开术(EST组),54例行内镜下乳头气囊扩张术(EPBD组),53例行内镜下乳头括约肌小切开联合气囊扩张术(sEST+EPBD组),均根据实际情况在乳头治疗后行取石篮取石和(或)气囊取石,部分患者以碎石篮碎石后取石.结果 与EST组比较,sEST+EPBD组术后并发症的发生率显著降低,出血发生减少,较EPBD组提高了一次取石的成功率,明显降低了术后高淀粉酶血症的发生率.结论 应用乳头括约肌小切开联合气囊扩张术治疗胆总管结石,术后并发症减少,在胆总管结石取石治疗中更为有效、安全.

Treatment of common duct stones in patients by small endoscopic sphincterotomycombined with endoscopic balloon dilatation

Objective To evaluate the effects of small endoscopic sphincterotomy combined with endoscopic balloon dilatation in treating patients with common duct stones(CDS).Methods One hundred and sixty-one patients with CDS treated from Jan.2010 to Sep.2011 were divided into three groups.Among which,54 patients underwent endoscopic sphincterotomy(EST group),54 cases underwent endoscopic balloon dilatation(EPBD group) and the remaining 53 patients underwent small endoscopic sphincterotomy combined with endoscopic balloon dilatation(sEST+EPBD group).We tried to remove all CDS using baskets and(or) balloons after three procedures metioned above on the papilla.In some patients the stones were crushed by mechanical lithotripsy.Results Patients in the sEST+EBPD group had a significantly decreased rate of complications,especially hemorrhage,when compared with the EST group.At the same time,the sEST+EPBD group had a higher success rate of complete stone removal,and decreased rate of hyperamylasemia when compared with the EPBD group(P <0.05).Conclusion Patients with common duct stones undergone small endoscopic sphincterotomy combined with endoscopic balloon dilatation have less complications,so it was effective and safe for the retrieval of common duct stones.