内镜逆行胰胆管造影治疗取石困难胆总管结石64例

目的:探讨内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)在取石困难胆总管结石中的应用价值.方法:连续收集64例取石困难胆总管结石患者,分析在ERCP术中操作的难点,巨大结石采用机械碎石、激光碎石、体外震波碎石法;胆总管畸形采用变换体位、反复吸引、网篮体外塑形法;胆管过度扩张或狭窄采用吸引或柱状气囊扩张法;结石坚硬采用反复缓慢加压碎石法再进行胆管取石.结果:64例取石困难者,经ERCP取石成功53例,总体取石成功率为82.81%.其中巨大结石者18例,取石成功15例,成功率83.33%;胆总管畸形者18例,取石成功14例,成功率77.78%;胆总管过度扩张或狭窄者19例,取石成功16例,成功率84.21%;结石坚硬者9例,取石成功8例,成功率88.89%.结论:ERCP术可以有效地治疗取石困难胆总管结石.

ERCP for refractory choledocholithiasis:An analysis of 64 cases

AIM:To evaluate the therapeutic value of en-doscopic retrograde cholangiopancreatography (ERCP) for refractory choledocholithiasis. METHODS:The clinical data for 64 patiens with refractory choledocholithiasis who underwent ERCP in the People’s Hospital of Guangxi were retrospectively analyzed. Stones were removed by breaking them into pieces,changing body positions,repeated extractions,or balloon dilatation. RESULTS:Stones were successfully removed in 53 patients,and the total success rate was 82.81%. Stones were successfully removed in 15 of 18 (83.33) patients with huge gallstones,14 of 18 (77.78%) patients with common bile duct malformation,16 of 19 (84.21%) patients withcommon bile duct dilatation or stenosis,and 8 of 9 (88.89%) patients with hard stones. CONCLUSION:ERCP is effective for treating refractory choledocholithiasis.