经内镜乳头括约肌切开治疗胆总管结石991例临床分析

目的 探讨内窥镜下十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)对胆总管结石的治疗效果.方法 总结1987年7月至2007年5月间实施的991例次EST治疗胆总管结石的经验,并对其中710例患者进行长期随访.结果 EST治疗胆总管结石991例,排出结石者909例(91.7%,909/991).EST后发生并发症59例(6.0%,59/991),其中急性胰腺炎29例(2.9%),术后出血18例(1.8%),急性胆管炎11例(1.1%),十二指肠穿孔1例(0.1%);991例中无死亡病例.随访710例中发生返流性胆管炎51例(7.2%,51/710),结石复发42例(5.9%,42/710).结论 EST治疗胆总管结石安全性高、疗效满意,是一种理想的微创外科方法.

Endoscopic sphincterotomy for choledocholithtasis

Objective To evaluate endoscopic sphincterotomy(EST)for the management of choledocholithiasis. Methods Between July 1987 and March 2007,991 cases of choledocholithiasis treated with EST were reviewed,and 710 cases were followed-up. Results All cases were treated with EST.The common bile duct stones were removed in 909 cases(91.7%,909/991).The rate of complications after EST was 6.0%(59/991)including pancreatitls in 29 cases(2.9%),hemorrhage in 18 cases(1.8%),cholangitis in 11 cases(1.1%),and duodenal perforation in 1 case(0.1%).There was no mortality in this group.Follow-up found reflux cholangitis in 51 cases(7.2%)and recurrent choledocholithiasis in 42 cases(5.9%). Conclusion Therapeutic endoscopy for choledocholithiasis is safe and effective.