十二指肠镜治疗胆总管结石的临床应用研究

目的评价十二指肠镜在胆总管结石治疗中的应用价值。方法胆总管结石患者,根据病情分别采用内镜下十二指肠乳头括约肌切开术、内镜下乳头括约肌气囊扩张术、网篮取石术、机械碎石术、气囊取石术,经内镜鼻胆管引流术等治疗。结果本组116例患者中,107例常规ERCP造影成功,成功率92.2%,行乳头预切开后及乳头开窗术后,113例ERCP造影成功,成功率为97.4%,取石成功110例,成功率94.8%。其中24例行机械碎石取石术,23例取石成功,碎石取石成功率95.8%,8例行单纯乳头括约肌气囊扩张取石术,7例成功,取石成功率87.5%。结论十二指肠镜治疗胆总管结石是一安全、有效的治疗方法。

The therapeutic application of duodenoscopic technique on common bile duct stone

Objective To evaluate the clinical application of therapeutic duodenoscopic technique on common bile duct stone(CBDs).Methods 116 cases of CBDs were diagnosed and treated with ERCP,papillary balloon dilation,EST and pre-cut.Results With the help of pre-cut technique,The successful rate diagnosis ERCP was 97.4%.The successful rate of EST CBDs removal was 94.8%.The one time successful rate in patients with large CBDs treated with EST and mechanical lithotripsy was 95.8%.The successful rate of endoscopic papillary balloon dilation for removal of CBDs was 87.5%.Bleeding after EST was 7.76%.Post-ERCP pancreatitis was 0.86%.Post-ERCP cholangitis was 0.86%.The mortality of post-ERCP complication was zero.Conclusion CBDs treated with therapeutic duodenoscopic technique was a simple,a safe and effective way.It can substitute traditional surgery operation.