两种胆总管结石手术的临床疗效比较

目的观察内镜下乳头小切开术(EST)联合球囊扩张术(EPBD)治疗胆总管结石的效果。方法选取192例胆总管结石患者随机分为EST组和EST+EPBD手术组各96例。对这两种手术的疗效进行评价。结果两组间平均手术时间、住院时间比较,EST+EPBD组均明显减少;一次性取石成功率及总取石成功率比较,EST+EPBD组均明显高于EST组。两组出血、胰腺炎、胆管内钡剂反流、结石复发等多项并发症比较,差异均有统计学意义(P0.05),EST+EPBD组术中、术后并发症显著减少。结论EST联合EPBD可极大地提高胆总管结石取石成功率和减少术后并发症,安全且疗效满意。

Comparison of clinical effects of two kinds of choledocholithiasis surgeries

Objective To observe the clinical effects of endoscopic sphincterotmy （EST） associated with endscopic papillary balloon dilatation （EPBD） in treatment of choledocholithiasis. Methods One hundred and ninety-two cases of choledocholithiasis were randomly divided into two groups, 96 cases in EST group were treated with EST only, while 96 cases in EST ＋ EPBD group were treated with EST ＋ EPBD, the efficacy of two groups was evaluated. Results There were significant differences in average operation time and hospitalization time between two groups （ P 〈 0.05 ） , those in EST ＋ EPBD group were markedly reduced. The one-time successful rate of stone removal and total successful rate of stone removal in EST ＋ EPBD group were evidently higher than those in EST group. There were significant differ- ences in bleeding, pancreatitis, biliary barium reflux, stone recurrence and other complications between two groups （P 〈 0.05） , the introperative and postoperative complications in EST ＋ EPBD group were sharply reduced. Conclusion It can raise the successful rate of operation and reduce postoperative complications that large common bile duct stones were treated with EST associated with EPBD. It is safe and has a satisfactory outcome.