十二指肠镜治疗肝外胆管残留和复发性结石31例临床分析

    Duodenoscopic treatment of residual extrahepatic bile duct stones:a report of 31 cases

    • 摘要: 目的:探讨十二指肠镜在胆囊切除或胆总管探查术后肝外胆管残留和复发性结石治疗中的价值。方法:对应用十二指肠镜治疗的31例肝外胆管残留和复发性结石患者的临床资料进行回顾分析。结果:31例患者经内镜逆行胰胆管造影术检查全部确诊为肝外胆管结石,成功行十二指肠乳头括约肌切开术治疗,治愈30例,治愈率约96.8%。术后1例因并发胆管炎中转剖腹手术,2例并发少量出血,4例出现一过性血淀粉酶升高。结论:内镜逆行胰胆管造影术对胆石症术后的并发症或其症状再发诊断价值高。十二指肠乳头括约肌切开术是非手术治疗肝外胆管残留和复发性结石的有效手段。

       

      Abstract: Objective:To explore the role of duodenoscope in treatment of residual and recurrent extrahepatic bile duct stones after cholecystectomy and choledochotomy.Methods:The clinical data of 31 patients undergoing duodenoscopic treatment for residual and recurrent extrahepatic bile duct stones were analyzed retrospectively.Results:All the 31 cases were diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) and treated by endosopic sphincterotomy (EST).Thirty out of 31 cases (96.8%) were cured.After operation,1 case was converted to open operation because of cholangitis,2 cases had slight bleeding and 4 cases got a transient increase in serum amylase.Conclusions:ERCP is of great value in diagnosis of recrudescences of commonbile duct stones and operational complications.EST is an effective means in non-operation treatment of extrahepatic bile duct stones.

       

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