内镜下不同直径十二指肠乳头气囊扩张术治疗胆总管结石疗效观察

周智强; 李能平

doi:10.13898/j.cnki.issn.1000-2200.2015.03.019

内镜下不同直径十二指肠乳头气囊扩张术治疗胆总管结石疗效观察

Effect of different diameters of endoscopic papillary balloon dilatation in the treatment of choledocholithiasis

摘要

摘要: 目的:探讨内镜下不同直径十二指肠乳头气囊扩张术(EPBD)治疗胆总管结石的有效性与安全性。方法:将胆总管结石患者按照最大结石直径分成≤5 mm、>5~8 mm、>8～<12 mm、12～<14 mm、≥14 mm组,分别行单纯小切口内镜下十二指肠乳头括约肌切开术(EST)、联合小切口EST的不同直径EPBD,气囊直径分别为8 mm、10 mm、12 mm、14 mm,观察各组术后近期并发症及随访并发症情况。结果:各组取石成功率均为100%,近、远期并发症中除胆管积气差异均有统计学意义(P<0.05)外,其他差异均无统计学意义(P >0.05)。结论:根据胆总管结石大小选择适当大小直径的气囊扩张联合小切口EST治疗胆总管结石是安全、有效的。需谨慎选择直径 >15 mm气囊。

Abstract: Objective:To evaluate the therapeutic efficacy and safety of different diameters of endoscopic papillary balloon dilation(EPBD) for removing common bile duct(CBD) stones.Methods:Patients with CBD stones were divided into 5 groups according to the maximum diameter of stone(≤5 mm,>5~8 mm,>8～<12 mm、12~<14 mm and ≥14 mm),and treated with single limited endoscopic sphincterotomy(EST) and limited EST combined with EPBD with diameter of 8 mm,10 mm,12 mm,and 14 mm balloons,respectively.The postoperative complications in all groups were observed.Results:The success rate of removing stone was 100% in each group.Except the difference of pneumobilia,the differences of other complications between short-and long-term in all groups were not statistically different(P>0.05).Conclusions:Choosing suitable balloon size for dilation according the diameter of stone combined with limited EST to remove CBD stone is safe and effective.Choosing the balloon diameter more than 15 mm needs to be cautious.

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