十二指肠乳头肌部分切开并气囊扩张取石术与胆管内压力变化的相关研究

目的:探讨应用内镜行十二指肠乳头括约肌部分切开并气囊扩张的方法治疗胆总管结石的可行性,此方法可保留乳头括约肌功能,使胆总管内压力不变,减少内镜治疗并发症。方法:应用十二指肠镜行十二指肠乳头括约肌部分切开(EST)和气囊扩张(EPBD),治疗胆总管结石108例,同时进行胆总管内压的测定,钡餐透视,观察有无胆道逆流情况,以鉴定乳头括约肌功能。结果:取石成功率98.15%,一次取净结石达86.79%,无出血、穿孔等严重并发症。远期观察胆总管内压力无明显改变,钡餐透视无钡剂胆道逆流情况。结论:内镜行十二指肠乳头括约肌部分切开并气囊扩张的方法治疗胆总管结石,能够达到与EST的同样效果,弥补了EPBD的不足,保留了十二指肠乳头括约肌的功能,减少了内镜治疗的并发症。

Related research on removing stones by EST partly with EPBD and the changes of choledochal inner pressure

Objective To probe into the feasibility in treating choledocholithiasis by means of performing endoscopic shpincterotomy partly with endoscopic papillary balloon dilatation, the method has on the function of duodenal sphincter muscles, can maintain normal choledochal inner pressure, remain the nature of duodenal papillary sphincter, reduce complication in endoscopy. Method By perform endoscopic sphincterotomy (EST) partly with endoscopic papillary balloon dilatation (EPBD), we had treated 108 cases of choledecholithiasis, at the same time, measured the choledochal inner pressure and observed whether there is biliary passage counter current using barium meal examination to determine the function of papillary muscle. Results Successful rate is 98.15%,successful rate of taking stones at one attempt is 86.79%.Serious camplication such as bleeding and perforation don't exit. Choledochal inner pressure has no obvious change and the biliary passage counter current hasn't been seen by using barium meal examination after three months. Conclusion Treatment for choledocholithiasis by means of performing duodenal sphincterotomy partly with balloon dilation can get the same effect as that of using EST, the method makes up the insufficiency in EPBD, retain the function of duodenal papillary sphincter and reduce the complications in endoscopy.