内镜下鼻胆管引流术在三镜联合模式治疗胆总管结石中的作用

目的:探讨内镜鼻胆管引流(ENBD)在三镜联合模式(EST加LC/LCBDE)治疗胆总管结石中的作用。方法:将93例胆总管结石患者随机分为试验组和对照组。试验组接受常规留置ENBD的EST加LC/LCBDE模式治疗,对照组接受不留置ENBD的EST加LC模式治疗。结果:两组在一般资料上比较差异无统计学意义(P>0.05)。试验组术后3 h、12 h、24 h和48 h血清淀粉酶水平均低于对照组(P<0.05)。试验组术中结石及时发现率高于对照组(5.88%vs 0%,P<0.05)。试验组治疗后结石残留率低于对照组(0%vs 9.52%,P<0.05),两组均无胆漏发生。结论:常规留置ENBD提高了EST加LC/LCBDE模式治疗胆总管结石的疗效和安全性。

The role of ENBD in the treatment mode of EST+LC/LCBDE

Objective To investigate the role of endoscopic nasobiliary drainage(ENBD) of bile duct in the treatment mode of endoscopic sphincterotomy(EST)+ laparoscopic cholecystectomy(LC)/laparoscopic common bile duct exploration(LCBDE).Methods 93 patients of CBD stones were enrolled into two groups randomly:trial group(EST+LC/LCBDE with ENBD) and control group(EST+LC without ENBD).Results No significant differences were observed in Baseline characteristics of the patients between two groups(P>0.05).The mean concentrations of serum amylase at the time points(3,l 2,24 or 48 hours after EST) were significantly lower in the trial group than in the control group(P<0.05).The intraoperative dectection rate of residual stones was higher in the trial group than in the control group(5.88% vs 0%,P<0.05).The residual stones rate after treatment was lower in the treatment than in the control group(0% vs 9.52%,P<0.05).No bile leakage happened in two groups.Conclusion ENBD improve the effect and the safety of the treatment mode of EST+LC/LCBDE.