单纯经内镜乳头球囊扩张术治疗胆总管结石的价值
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南京鼓楼医院集团宿迁市人民医院消化科

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宿迁市社会发展基金(S201719);宿迁市千名领军人才集聚计划(201905)


Therapeutic value of endoscopic papillary balloon dilation for common bile duct stones
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Suqian People''s Hospital of Nanjing Gulou Hospital Group

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Suqian City Social Development Fund(S201719);Thousands of Leading Talents Spooling Plan of Suqian City (201905)

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    摘要:

    目的初步研究单纯经内镜乳头球囊扩张术治疗胆总管结石的安全性和有效性。方法根据入选标准和排除标准,共纳入南京鼓楼医院集团宿迁市人民医院2017年1月—2018年12月期间住院的胆总管结石患者60例,按照随机数字表法将患者分为单纯经内镜乳头球囊扩张取石组(EPBP组,n=30)及经内镜乳头括约肌小切开联合球囊扩张取石组(ESBD组,n=30)。比较经内镜取石时间、X线暴露时间、一次性取石率、碎石率及术后急性胰腺炎发生率、术中及术后出血率等指标。结果EPBD组和ESBD组取石时间[(8.5±2.4)min 比(7.8±2.1)min, P=0.14]、X线暴露时间[(21.8±5.2)min 比 (19.7±6.3) min, P=0.11]相比,差异均无统计学意义。两组患者均一次性取完结石,无需要碎石器病例。两组ERCP术后急性胰腺炎发生率均为(6.67%,2/30)。EPBD组和ESBD组术中出血率[3.33%(1/30)比 10.00%(3/30),P=0.042]、术后出血率[0 比 3.33%(1/30),P=0.035]相比,差异均有统计学意义。两组均未发生其他近期并发症。结论单纯经内镜乳头球囊扩张术治疗胆总管结石安全、有效。

    Abstract:

    ObjectiveTo study the safety and efficacy of endoscopic papillary balloon dilation for choledocholithiasis. MethodsA total of 60 patients with choledocholithiasis in Suqian People's Hospital of Nanjing Drum Tower Hospital Group were included from January 2017 to December 2018 according to the inclusion and exclusion criteria. According to the random number table, the patients were divided into two groups: simple endoscopic papillary balloon dilation group (EPBD group, n=30) and endoscopic papillary sphincterotomy combined with balloon dilation group (ESBD group, n=30). Lithotripsy time, X-ray exposure time, one-time lithotripsy rate, lithotripsy rate, incidence of postoperative acute pancreatitis, intraoperative and postoperative bleeding rates were compared. ResultsThe time of stone extraction (8.5±2.4 min) in EPBD group was comparable with that of group ESBD (7.8±2.1 min) (P=0.14). The time of X-ray exposure was 21.8±5.2 min in EPBD group and 19.7±6.3 min in ESBD group (P=0.11). Stones were extracted at one time in all 60 patients, and no lithotripsy was conducted. The incidences of acute pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP) in the two groups were both 6.67% (2/30). The intraoperative bleeding rates were 3.33% (1/30) and 10.00% (3/30) in EPBD group and ESBD group (P=0.042), respectively. The rate of postoperative bleeding was 3.33% (1/30) in ESBD group (P=0.035). No other recent complications occurred in the two groups. ConclusionEndoscopic papillary balloon dilation alone is safe and effective in the treatment of choledocholithiasis.

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李运红,朱美玲,刘加宁,等.单纯经内镜乳头球囊扩张术治疗胆总管结石的价值[J].中华消化内镜杂志,2020,37(6):425-428.

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  • 收稿日期:2019-03-13
  • 最后修改日期:2020-04-15
  • 录用日期:2019-05-24
  • 在线发布日期: 2020-06-28
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