内镜下EST对胆囊术后胆总管结石患者治疗价值及安全性评估

目的探讨内镜下括约肌切开术（EST）对胆囊术后胆总管结石患者治疗价值及安全性。方法回顾性分析近3年来我院120例胆囊切除术（LC）术后胆总管结石患者进行EST切开取石和鼻胆管引流治疗。结果120例患者117例获成功，3例手术失败，入院时症状如黄疸、发热、上腹胀痛不适等均明显改善。术后并发症，一过性高淀粉酶血症65例，活动性出血2例，ERCP术后急性胰腺炎13例，胆管炎4例，无一例胆瘘及死亡患者。结论EST治疗胆囊术后患者胆总管结石不失为一种疗效确切、安全系数较高的微创治疗胆石症的最佳方法。

The Evaluation of Safety and Therapeutic Value of Endoscopic Sphincterotomy(EST) by Endoscope to the Patients Suffering from Common Duct Stones After Their Gallbladders Resected

Objective Exploring the evaluation of safety and therapeutic value of endoscopic sphincterotomy by endoscope to the patients suffering from common duct stones after their gallbladders resected. Methods 120 patients suffering from common duct stones with their gallbladders resected were given the treatments of endoscopic sphincterotomy and nasobiliary drainage in recent 3 years. Results 117 of 120 patients got succeed. The symptoms obviously improved such as jaundice and fever and epigastric distention and so on. As for the postoperative complications, the hyperamylasemia occurred in 65 patients of all patients ,and reactiveness hemorrhage in 2 patients, and acute pancreatitis in 13 patients,and cholangitis in 4 patients ,but no one occurred biliary fistula , no one died, too. Conclusions EST is the best way for us to treat the patients suffering from common duct stones after their gallbladders resected by endoscope ,and its curative effect is sure and its safety coefficient higher.